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. 2024 Dec;14(4):1609-1618.
doi: 10.1007/s44197-024-00313-6. Epub 2024 Oct 14.

Temporal Trends and Mortality Patterns in Peripheral Arterial Disease: A Comprehensive Analysis of Hospitalized Patients in Kazakhstan between 2014 and 2021

Gulnur Zhakhina  1 , Yesbolat Sakko  2 , Sauran Yerdessov  1 , Temirgali Aimyshev  1 , Zhalaliddin Makhammajanov  2 , Anara Abbay  1 , Denis Vinnikov  3   4 , Ildar Fakhradiyev  5 , Zhanar Yermakhanova  6 , Yalcin Solak  7 , Alessandro Salustri  1 , Abduzhappar Gaipov  8   9   10
Affiliations

Temporal Trends and Mortality Patterns in Peripheral Arterial Disease: A Comprehensive Analysis of Hospitalized Patients in Kazakhstan between 2014 and 2021

Gulnur Zhakhina et al. J Epidemiol Glob Health. 2024 Dec.

Abstract

Background: Peripheral artery disease (PAD) is a global health concern associated with arterial narrowing or blockage, leading to significant morbidity and mortality. The aim of this study is to assess the disease burden and trends in mortality utilizing nationwide administrative health data.

Methods: This retrospective study utilized data from the Unified National Electronic Healthcare System (UNEHS) from 2014 to 2021. Patients meeting PAD criteria were included, with demographic and clinical data analyzed. Cox regression and Competing Risk Analysis assessed mortality risks.

Results: Between 2014 and 2021, 19,507 individuals were hospitalized due to PAD, with 8,332 (43%) being women and 11,175 (57%) men. The incidence of PAD increased markedly over the observation period, rising from 79 individuals per million population (PMP) in 2014 to 309 PMP in 2021. Concurrent heart failure (HF), acute myocardial infarction (AMI), diabetes, and essential hypertension were prevalent in 50%, 27%, 27%, and 26% of the PAD patients, respectively. Competing Risk Analysis showed a subdistribution hazard ratio (SHR) of 6.53 [95% CI: 4.65-9.19] for individuals over 80 years. Heart failure was associated with lower all-cause HR [0.80, 95% CI: 0.76-0.86, p < 0.001] but higher SHR [1.30, 95% CI: 1.18-1.44, p < 0.001]. Comorbidities such as heart failure, stroke, and acute myocardial infarction significantly increased mortality risks, while essential hypertension was associated with lower risk of death.

Conclusion: The significant rise in the incidence rate of PAD underscores the growing burden of the disease, highlighting the urgent need for targeted preventive and management strategies in Kazakhstan.

Keywords: Charlson Comorbidity Index; Competing risk Analysis; Nationwide Administrative data; Peripheral Artery Disease (PAD); Vascular Disease.

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Conflict of interest statement

Declarations. Ethics Approval and Consent to Participate: The study was approved by the Institutional Review Ethics Committee of Nazarbayev University (NU-IREC 490/18112021), with exemption from informed consent. Consent for Publication: Not applicable. Competing Interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Average age- and sex-specific incidence of PAD in Kazakhstan between 2014–2021
Fig. 2
Fig. 2
Incidence, all-cause mortality and cause-specific mortality of PAD patients in Kazakhstan by years: (a) rate per million population; (b) absolute numbers
See this image and copyright information in PMC

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References

    1. Aboyans V et al. Questions and answers on diagnosis and management of patients with peripheral arterial diseases: a companion document of the 2017 ESC guidelines for the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS) endorsed by: the European Stroke Organisation (ESO) the Task Force for the diagnosis and treatment of peripheral arterial diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J, 39, no. 9, pp. e35-e41, 2018. - PubMed
    1. Schieber MN, et al. Muscle strength and control characteristics are altered by peripheral artery disease. J Vasc Surg. 2017;66(1):178–86. - PMC - PubMed
    1. Attar R, Wester A, Koul S, Eggert S, Andell P. Peripheral artery disease and outcomes in patients with acute myocardial infarction. Open Heart. 2019;6(1):e001004. - PMC - PubMed
    1. Zito C, Manganaro R, Carerj S, Antonini-Canterin F, Benedetto F. Peripheral artery disease and stroke. J Cardiovasc Echography. 2020;30(Suppl 1):S17–S. - PMC - PubMed
    1. Agnelli G, Belch JJF, Baumgartner I, Giovas P, Hoffmann U. Morbidity and mortality associated with atherosclerotic peripheral artery disease: A systematic review, Atherosclerosis, vol. 293, pp. 94–100, 2020. - PubMed