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Study Title
Prevalence of peripheral arterial disease in acute coronary Syndrome patients
Investigator(s): Vlceanu Alexandra Ctlina (Seria 3,Grupa 27 )
Data set:Esant 3028
Objectives:
Primary:
To evaluate the prevalence of Peripheral Arterial Disease (PAD) in patients admitted in
hospital with diagnosis of ACS or outpatients after an ACS (within last 6 months),
ambulatory checked.
Secondary:
To identify the Main Clinical Variables associated with a higher risk of PAD among this
population
To evaluate the therapeutic management of these patients
To train Cardiologists to measure Ankle / Brachial Index (ABI) in order to improve diagnosis of
PAD
Methodology: open-label, non-randomized, national, multicentric, prospective, noninterventional study
Number of patients/subjects: 100
Evaluated:
ABI (Cut-off for PAD 0,9)
Epidemiological data:
atherothrombotic risk factors
cardiovascular previous events
treatments prescribed at visit 1 (by therapeutic class)
Diagnosis and criteria for inclusion:
Inclusion Criteria: patients > 40 years admitted in hospital with diagnosis of Acute
Coronary Syndrome or outpatients after an ACS (within last 6 months), ambulatory
checked; informed consent signed
Exclusion Criteria: patients < 40 years; patients who did not sign the informed consent
form; patients enrolled in other studies
Criteria for evaluation:
Will be collected: demographic data of the patient, cardiovascular risk factors, personal
history of cardiovascular diseases, clinical data, diagnosis of coronary disease, Ankle-Brachial
Index (ABI), antiplatelet treatment recommended at baseline.
Summary:
Population studied: 100 patients, with the following gender distribution:70% male and
30% female and with mean age of 64.42 years (63.44 years in male group, respective 66.70
years in female one).
Cardiovascular risk factors
Cardiovascular risk factors
Hypertension
Diabetes mellitus
Smoking/History of smoking
Dyslipemia
Family history of cardiovascular
disease
No
Count
22
Column N %
22%
Yes
No
Yes
No
Yes
No
Yes
No
Yes
78
68
32
37
63
22
78
40
60
78%
68%
32%
37%
63%
22%
78%
40%
60%
142.0
4
84.0
2
76.96
Missing
ABI 0.9
33
33%
ABI< 0.9
65
65%
Total
98
98%
2%
Total
100
100%
98
98%
Missing
2%
Total
100
100%
23
23%
Acetylsalicylic acid
Acetylsalicylic acid +
Thienopyridine + Others
No treatment
Thienopyridine + Others
5
2
5%
2%
3
1
3%
1%
0
0
0%
0%
Total
100
100.0%
Myocardial infarction
Stroke/TIA
No
98
98%
Yes
2%
No
99
99%
Yes
1%
No
98
98%
Yes
2%
60% of the major cardiovascular events (vascular death, myocardial infarction and stroke/TIA)
occurred during the 6 months of follow up in the group of patients with ABI values < 0.9 and only
40% in those with normal ABI values.
Conclusions:
The prevalence of Peripheral Arterial Disease (PAD) based on ABI measurement in the cohort
of 100 patients admitted to hospital with diagnostic of ACS or outpatients after an ACS (within
last 6 months), ambulatory checked was of 65% (65 patients with ABI values < 0.9). ABI
measurement is also considered as a generalized atherosclerotic marker that may allow
identifying patients at high risk for developing cardio or cerebrovascular events: on top of the
patients with ABI values lower than 0.9 there were those ones with ABI values > 1.4 ( 0%)
indicating arterial stiffness and, as already mentioned, risk of major cardiovascular events.
The main variables associated with a higher risk of PAD that have been identified among this
population were the following risk factors: hypertension, diabetes mellitus, present smoking or
history of smoking and history of cardiovascular diseases (p values of statistical significance are
illustrated below):
Risk factors
Hypertension
Diabetes
mellitus
Smoking
Dyslipemia
History CV
disease
Odds Ratio
(95% Cl)
1,11 (0,403,07)
1,38 (0,563,36)
0,43 (0,181,04)
0,36 (0,130,97)
0,70 (0,301,64)
X2
used
0,002
p-value
1,07 (0,54-2,13)
X2
uncorrected
0,04
1,23 (0,70-2,17)
0,51
0,23
0,47
0,59 (0,34-1,01)
3,53
2,74
0,06
0,54 (0,31-0,93)
4,18
3,18
0,04
0,79 (0,45-1,37)
0,66
0,35
0,41
0,83
The logistic regression calculation (taking into account all these risk factors simultaneously)
identified that hypertension, diabetes mellitus, present smoking or history of smoking,
dyslipemia as well as history of cardiovascular disease are all risk factors with major impact on
Peripheral Arterial Disease induction.
60% of the major cardiovascular events (vascular death, myocardial infarction and stroke/TIA)
occurred during the 6 months of follow up in the group of patients with ABI values < 0.9 and only
40% in those with normal ABI values.
97% of the patients were on antiplatelet treatment at the inclusion visit: 73% acetylsalicylic
acid, 92% thienopyridine and 6% others, as monotherapy or in combinations.
Date of report:20/01/2016
100.00%
90.00%
85.00%
80.00%
70.00%
60.00%
58.00%
50.00%
40.00%
31.00%
30.00%
20.00%
31.00%
27.00%
10.00%
0.00%
27.00%
15.00%
ANGINA PECTORIS
IMA
Frecvente relative
Absent
CICD
Frecvente cumulate
36.00%
35.00%
30.00%
26.00%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00%
10.00%
8.00%
5.00%
5.00%
4.00%
0.00%
6.00%