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Study Title
Prevalence of peripheral arterial disease in acute coronary Syndrome patients
Investigator(s): Josanu Radu(seria 4, grupa 44)
Data set: 4078
Objectives:
Primary:
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
Summary:
Population studied: 100 patients, with the following gender distribution: 71% male and 29%
female and with mean age of 64.93 years( 64.97 years in male group, respective 64.89 years in
female one).
Cardiovascular risk factors
Cardiovascular risk factors
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
Hypertension
Diabetes mellitus
Smoking / History of smoking
Dyslipemia
Family history of cardiovascular disease
Count
Column N %
23
77
67
33
30
70
29
71
44
56
23
77
67
33
30
70
29
71
44
56
SBP
DBP
Heart Rate
99
1
99
1
98
2
140.99
81.23
75.62
ABI measurement
ABI 0.9
N
ABI< 0.9
Total
Missing
Total
Frequency
36
64
100
0
100
Percent
36%
64%
100%
0%
100.0%
Frequency
1
35
64
100
0
100
Percent
1%
35%
64%
100%
0%
100.0%
Frequency
Percent
Acetylsalicylic acid +
Thienopyridine
Thienopyridine
Acetylsalicylic acid
Acetylsalicylic acid +
Thienopyridine + Others
No treatment
Thienopyridine + Others
Acetylsalicylic acid + Others
Others
Total
60
60%
29
6
2
29%
6%
2%
1
1
1
0
100
1%
1%
1%
0%
100.0%
Count
100
0
100
Column N%
100%
0%
100%
Stroke / TIA
Yes
No
Yes
0
100
0
0%
100%
0%
0% 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
0% 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 64% (64 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 (1%)
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
Odds Ratio
Risk Ratio (95% X2 uncorrected
X2 used
p-value
(95% CI)
CI)
Hypertension
0.76(0.28-2.08) 0.91(0.66-1.25) 0.6
0.075
0.7841
Diabetes
1.37(0.56-3.34) 1.11(0.83-1.48)
0.478
0.219
0.6397
mellitus
Smoking
2.04(0.84-4.92) 1.31(0.91-1.9)
2.654
1.884
0.1699
Dyslipemia
0.77(0.31-1.96) 0.92(0.68-1.24) 0.282
0.09
0.7639
History CV
0.65(0.27-1.50
2.05(1.24-3.4)
1.028
0.644
0.4223
disease
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.
0% 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
0% in those with normal ABI values.
99% of the patients were on antiplatelet treatment at the inclusion visit: 69% acetylsalicylic acid,
32% thienopyridine and 4% others, as monotherapy or in combinations.
160.00
140.00
120.00
100.00
40
45
50
55
60
65
70
75
80
85
Age
100.00
90.00
80.00
70.00
60.00
40.00
60.00
80.00
Weight
100.00
120.00
140.00