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Peripheral Artery
Disease Predicts Cardiac Death in Patients With Diabetes
posted 04/20/2006
PAD is common in patients with type
2 diabetes and predicts cardiac death, supporting the role of regular screening
for PAD in these patients.
A group of researchers led by Professor Paul Norman of Fremantle Hospital,
Australia, examined the relationship between peripheral artery disease (PAD)
related to type 2 diabetes and the risk of cardiac death. Between 1993 and 1996,
a total of 1,294 patients were enrolled in the Fremantle Diabetes Study, a
prospective, community-based observational study. Of these patients, 531 had
valid data collected at baseline and 5 or more subsequent consecutive annual
reviews. A range of clinical and biochemical factors were assessed, including
the ankle/brachial index (ABI). For this study, PAD was defined as an ABI 0.90
or less at 2 consecutive reviews, or any PAD-related amputation of the lower
extremities.
The researchers found that an ABI 0.90 or less was independently associated with an increased risk of cardiac death of 67%. Overall, the prevalence of PAD at baseline was 13.6%. The incidence of new PAD was 3.7 per 100 patient-years. The prevalence and incidence were associated with increasing age, systolic blood pressure, total serum cholesterol, and smoking. Management of risk factors for PAD improved during follow-up but remained suboptimal.
The researchers concluded that PAD was common in patients with type 2
diabetes and predicted cardiac death, supporting the role of regular screening
for PAD in these patients.