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Cited by 2,579Peripheral Artery Disease ManagementCardiovascular Health and Disease PreventionHealthcare Systems and Public Health

Mortality over a Period of 10 Years in Patients with Peripheral Arterial Disease

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Criqui, Michael H., Langer, Robert D., Fronek, Arnost, Feigelson, Heather S., Klauber, Melville R., McCann, Theresa J., Browner, Deirdre·1992·New England Journal of Medicine
DOI 10.1056/nejm199202063260605
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Abstract

BACKGROUND: Previous investigators have observed a doubling of the mortality rate among patients with intermittent claudication, and we have reported a fourfold increase in the overall mortality rate among subjects with large-vessel peripheral arterial disease, as diagnosed by noninvasive testing. In this study, we investigated the association of large-vessel peripheral arterial disease with rates of mortality from all cardiovascular diseases and from coronary heart disease. METHODS: We examined 565 men and women (average age, 66 years) for the presence of large-vessel peripheral arterial disease by means of two noninvasive techniques--measurement of segmental blood pressure and determination of flow velocity by Doppler ultrasound. We identified 67 subjects with the disease (11.9 percent), whom we followed prospectively for 10 years. RESULTS: Twenty-one of the 34 men (61.8 percent) and 11 of the 33 women (33.3 percent) with large-vessel peripheral arterial disease died during follow-up, as compared with 31 of the 183 men (16.9 percent) and 26 of the 225 women (11.6 percent) without evidence of peripheral arterial disease. After multivariate adjustment for age, sex, and other risk factors for cardiovascular disease, the relative risk of dying among subjects with large-vessel peripheral arterial disease as compared with those with no evidence of such disease was 3.1 (95 percent confidence interval, 1.9 to 4.9) for deaths from all causes, 5.9 (95 percent confidence interval, 3.0 to 11.4) for all deaths from cardiovascular disease, and 6.6 (95 percent confidence interval, 2.9 to 14.9) for deaths from coronary heart disease. The relative risk of death from causes other than cardiovascular disease was not significantly increased among the subjects with large-vessel peripheral arterial disease. After the exclusion of subjects who had a history of cardiovascular disease at base line, the relative risks among those with large-vessel peripheral arterial disease remained significantly elevated. Additional analyses revealed a 15-fold increase in rates of mortality due to cardiovascular disease and coronary heart disease among subjects with large-vessel peripheral arterial disease that was both severe and symptomatic. CONCLUSIONS: Patients with large-vessel peripheral arterial disease have a high risk of death from cardiovascular causes.

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Authors
Criqui, M. H., Langer, R. D., Fronek, A., Feigelson, H. S., Klauber, M. R., McCann, T. J., & Browner, D.
Affiliations
University of California San Diego (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1992-02-06
Volume
326
Issue
6
Pages
381-386
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199202063260605
OpenAlex
W2315630371
Cited by
2,579
References
27
Citations by year
2026: 22 · 2025: 43 · 2024: 61 · 2023: 47 · 2022: 82 · 2021: 74 · 2020: 64 · 2019: 78 · 2018: 89 · 2017: 81 · 2016: 111 · 2015: 92 · 2014: 122 · 2013: 120 · 2012: 120
FWCI
40.67
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (3r01hl022255-04s4)
  • National Heart, Lung, and Blood Institute (HL 42973, R01HL042973, HL 22255)
Topics
  • Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
Keywords
peripheral arterial disease, mortality, cardiovascular mortality, coronary artery disease, intermittent claudication, Doppler ultrasound, non-invasive diagnosis, relative risk of death
MeSH terms
Adult, Aged, Blood Pressure, Cardiovascular Diseases, Coronary Disease, Female, Follow-Up Studies, Humans, Intermittent Claudication, Male, Middle Aged, Prospective Studies, Risk, Ultrasonics

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