TY - JOUR
T1 - Self-reported peripheral arterial disease predicts future vascular events in a community-based cohort
AU - Salameh, Maya J.
AU - Rundek, Tatjana
AU - Boden-Albala, Bernadette
AU - Jin, Zhezhen
AU - Ratchford, Elizabeth V.
AU - Di Tullio, Marco R.
AU - Homma, Shunichi
AU - Sacco, Ralph L.
N1 - Funding Information:
Funding/Support: This work was supported by grants from the National Institute of Neurological Disorders and Stroke (R01 NS 29993, T32 NS 07153) and the General Clinical Research Center (2 M01 RR00645). The funding organizations had no role in the design and conduct of the study, in the collection, analysis, or interpretation of the data, or in the decision to approve publication of the manuscript.
Funding Information:
Acknowledgments: This work was supported by grants from the National Institute of Neurological Disorders and Stroke (R01 NS 29993, T32 NS 07153) and the General Clinical Research Center (2 M01 RR00645). The data were presented in part in abstract form at the 18th Annual American Heart Association Scientific Sessions in November 2006.
PY - 2008/9
Y1 - 2008/9
N2 - BACKGROUND: Lower extremity peripheral arterial disease (PAD) is highly prevalent and strongly associated with cardiovascular morbidity and mortality. The ankle-brachial index used to screen for PAD is not routinely performed in primary care settings. OBJECTIVE: To determine if self-reported PAD is an independent predictor of combined vascular events (myocardial infarction, ischemic stroke, and vascular death). DESIGN: Ongoing population-based prospective cohort (the Northern Manhattan Study). Subjects enrolled between July 1993 and June 2001 with a mean follow-up time of 7.1 years. PATIENTS: Subjects (n=2,977), aged 40 years or older and free of prior stroke or myocardial infarction, were classified as having self-reported PAD if they answered affirmatively to one of two questions regarding exercise-induced leg pain or a prior diagnosis of PAD. MAIN OUTCOME MEASURES: Combined vascular outcome defined as incident myocardial infarction, incident ischemic stroke, or vascular death. RESULTS: The mean age of the cohort was 68.9±10.4 years; 64% were women; 54% Hispanic, 25% African-American, 21% Caucasian; 15% reported having PAD. After a mean follow-up of 7.1 years, self-reported PAD was significantly predictive of combined events (n=484) in the univariate model (HR 1.5, 95% CI, 1.2-1.9) and after adjustment for traditional cardiovascular risk factors (HR 1.3, 95% CI, 1.0-1.7). CONCLUSION: Self-reported PAD is an independent risk factor for future vascular events in this predominantly non-white cohort. The addition of two simple PAD questions to the routine medical history in general medicine settings could identify high-risk patients who would benefit from further vascular evaluation and risk factor modification.
AB - BACKGROUND: Lower extremity peripheral arterial disease (PAD) is highly prevalent and strongly associated with cardiovascular morbidity and mortality. The ankle-brachial index used to screen for PAD is not routinely performed in primary care settings. OBJECTIVE: To determine if self-reported PAD is an independent predictor of combined vascular events (myocardial infarction, ischemic stroke, and vascular death). DESIGN: Ongoing population-based prospective cohort (the Northern Manhattan Study). Subjects enrolled between July 1993 and June 2001 with a mean follow-up time of 7.1 years. PATIENTS: Subjects (n=2,977), aged 40 years or older and free of prior stroke or myocardial infarction, were classified as having self-reported PAD if they answered affirmatively to one of two questions regarding exercise-induced leg pain or a prior diagnosis of PAD. MAIN OUTCOME MEASURES: Combined vascular outcome defined as incident myocardial infarction, incident ischemic stroke, or vascular death. RESULTS: The mean age of the cohort was 68.9±10.4 years; 64% were women; 54% Hispanic, 25% African-American, 21% Caucasian; 15% reported having PAD. After a mean follow-up of 7.1 years, self-reported PAD was significantly predictive of combined events (n=484) in the univariate model (HR 1.5, 95% CI, 1.2-1.9) and after adjustment for traditional cardiovascular risk factors (HR 1.3, 95% CI, 1.0-1.7). CONCLUSION: Self-reported PAD is an independent risk factor for future vascular events in this predominantly non-white cohort. The addition of two simple PAD questions to the routine medical history in general medicine settings could identify high-risk patients who would benefit from further vascular evaluation and risk factor modification.
KW - Claudication
KW - Ischemic stroke
KW - Myocardial infarction
KW - Peripheral arterial disease
KW - Vascular events
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U2 - 10.1007/s11606-008-0694-x
DO - 10.1007/s11606-008-0694-x
M3 - Article
C2 - 18581186
AN - SCOPUS:50149096789
SN - 0884-8734
VL - 23
SP - 1423
EP - 1428
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 9
ER -