TY - JOUR
T1 - Prevalence and Outcomes of Undiagnosed Peripheral Arterial Disease Among High Risk Patients in Australia
T2 - An Australian REACH Sub-Study
AU - Si, Si
AU - Golledge, Jonathan
AU - Norman, Paul
AU - Nelson, Mark
AU - Chew, Derek
AU - Ademi, Zanfina
AU - Bhatt, Deepak L.
AU - Steg, Gabriel P.
AU - Reid, Christopher M.
PY - 2019/6
Y1 - 2019/6
N2 - BackgroundCompared
with other manifestations of cardiovascular disease, peripheral
arterial disease (PAD) is under-diagnosed. This study aims to
investigate the prevalence, risk profile and cardiovascular outcomes of
undiagnosed PAD in Australian general practices.MethodA sub-study of the Australian Reduction of Atherothrombosis for Continued Health (REACH) Registry, a prospective cohort study
of patients at high risk of atherothrombosis recruited from Australian
general practices. Eligible patients for this study had no previous
clinical diagnosis of PAD and had an ankle-brachial index (ABI) ≤1.4 at recruitment.ResultsPeripheral arterial disease was undiagnosed in 34% Australian REACH participants, 28% patients had low ABI (ABI < 0.9) and 11% had intermittent claudication (IC) based on responses to the Edinburgh Claudication
Questionnaire (ECQ). We found no significant differences in risk factor
control between patient with or without PAD. Intermittent claudication
patients had higher risks of non-fatal cardiovascular events and PAD
interventions at one year, whereas all-cause mortality rate was higher among patients with ABI<0.9, especially in those who also reported IC. Finally, an ABI < 0.9, together with poorly controlled risk factors were independent predictors of incident IC at one year.ConclusionsThis
study suggests a high rate of undiagnosed PAD among high risk patients
in Australian primary health care. These patients are at high risk of
events and therefore would potentially benefit from better secondary
prevention measures.
AB - BackgroundCompared
with other manifestations of cardiovascular disease, peripheral
arterial disease (PAD) is under-diagnosed. This study aims to
investigate the prevalence, risk profile and cardiovascular outcomes of
undiagnosed PAD in Australian general practices.MethodA sub-study of the Australian Reduction of Atherothrombosis for Continued Health (REACH) Registry, a prospective cohort study
of patients at high risk of atherothrombosis recruited from Australian
general practices. Eligible patients for this study had no previous
clinical diagnosis of PAD and had an ankle-brachial index (ABI) ≤1.4 at recruitment.ResultsPeripheral arterial disease was undiagnosed in 34% Australian REACH participants, 28% patients had low ABI (ABI < 0.9) and 11% had intermittent claudication (IC) based on responses to the Edinburgh Claudication
Questionnaire (ECQ). We found no significant differences in risk factor
control between patient with or without PAD. Intermittent claudication
patients had higher risks of non-fatal cardiovascular events and PAD
interventions at one year, whereas all-cause mortality rate was higher among patients with ABI<0.9, especially in those who also reported IC. Finally, an ABI < 0.9, together with poorly controlled risk factors were independent predictors of incident IC at one year.ConclusionsThis
study suggests a high rate of undiagnosed PAD among high risk patients
in Australian primary health care. These patients are at high risk of
events and therefore would potentially benefit from better secondary
prevention measures.
KW - Ankle-brachial index
KW - Australian primary health care
KW - Intermittent claudication
KW - Peripheral arterial disease
UR - http://www.scopus.com/inward/record.url?scp=85047395370&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2018.04.292
DO - 10.1016/j.hlc.2018.04.292
M3 - Article
C2 - 29843973
AN - SCOPUS:85047395370
VL - 28
SP - 939
EP - 945
JO - Heart, Lung and Circulation
JF - Heart, Lung and Circulation
SN - 1443-9506
IS - 6
ER -