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Control of modifiable risk factors and major adverse cardiovascular events in people with peripheral artery disease and diabetes

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World Journal of Diabetes 2021年第6期12卷 883-892页

作者： Jonathan Golledge Aaron Drovandi Sophie Rowbotham Ramesh Velu frank quigley Jason Jenkins Queensland Research Centre for Peripheral Vascular Disease College of Medicine and DentistryJames Cook UniversityTownsville 4811QueenslandAustralia Department of Vascular and Endovascular Surgery Townsville University HospitalTownsville 4811QueenslandAustralia Department of Vascular Surgery Mater HospitalTownsville 4811QueenslandAustralia Department of Vascular Surgery The Royal Brisbane and Women's HospitalBrisbane 4000QueenslandAustralia

BACKGROUND People with diabetes and peripheral artery disease(PAD)have a high risk of major adverse cardiovascular events(MACE).Prior research suggests that medical therapies aimed to control modifiable risk factors are poorly implemented in patients with *** To examine the association between the control of modifiable risk factors,estimated by the novel PAD-medical score,and the incidence of MACE in people with PAD and *** Participants were recruited from out-patient clinics if they had a diagnosis of both PAD and *** of reversible risk factors was assessed by a new composite measure,the PAD-medical *** score takes into account the control of low-density lipoprotein cholesterol,blood pressure,blood glucose,smoking and prescription of an *** were followed to record incidence of myocardial infarction,stroke and cardiovascular death(MACE).The association of PAD-medical score with MACE was assessed using Cox proportional hazard analyses adjusting for age,sex and prior history of ischemic heart disease and *** Between 2002 and 2020,a total of 424 participants with carotid artery disease(n=63),aortic or peripheral aneurysm(n=121)or lower limb ischemia(n=240)were prospectively recruited,and followed for a median duration(inter-quartile range)of 2.0(0.2–4.4)*** 33(7.8%)participants had the optimal PAD-medical score of five,with 318(75%)scoring at least three out of *** were 89(21.0%)participants that had at least one MACE during the follow-up period.A one-unit higher PAD-medical score was associated with lower risk of MACE(HR=0.79,95%CI:0.63-0.98)after adjusting for other risk *** The PAD-medical score provides a simple way to assess the control of modifiable risk factors targeted by medical management aimed to reduce the incidence of MACE.

关键词： Peripheral artery disease Diabetes Major cardiovascular events Medical management Prospective study Clinical practice

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