Cited by 169Peripheral Artery Disease ManagementAtherosclerosis and Cardiovascular DiseasesVascular Procedures and Complications

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Peripheral artery disease and risk of cardiovascular events in patients with coronary artery disease: Insights from the Heart and Soul Study

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Grenon, S Marlene, Vittinghoff, Eric, Owens, Christopher D, Conte, Michael S, Whooley, Mary, Cohen, Beth E·2013·Vascular Medicine

DOI 10.1177/1358863x13493825PMC PMC4207208

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Abstract

Among patients with coronary artery disease (CAD), those with peripheral artery disease (PAD) have a greater vulnerability to cardiovascular (CV) events than those with CAD alone. In a prospective cohort study of patients with CAD, we evaluated potential mechanisms that might explain the adverse CV outcomes associated with PAD. We performed a prospective cohort study of 1018 patients with stable CAD who were recruited from 2000 to 2002. Incident symptomatic PAD events were adjudicated during a follow-up period of 7.2 ± 2.6 years. We used Cox proportional hazards models to evaluate the association between incident symptomatic PAD events and subsequent risk of CV events or death. Models were adjusted for demographics, traditional risk factors, inflammation, insulin resistance and health behaviors. Among the 1018 patients, 50 patients who did not report a history of PAD at baseline suffered incident symptomatic PAD events during the follow-up period. Those patients had a higher risk of subsequent CV events and death compared to those who did not develop PAD. After adjustment for traditional risk factors, symptomatic PAD events remained associated with a 70% increased risk of subsequent CV events (adjusted HR 1.7; 95% CI 1.0, 2.9; p = 0.04) and an 80% increased risk of death (adjusted HR 1.8; 95% CI 1.2, 2.7; p = 0.006). Inflammatory biomarkers were the strongest risk factor contributing to the excess risk. In a contemporary cohort of patients with CAD, incident symptomatic PAD events were associated with an increased risk for subsequent CV events. The increased vulnerability to CV events was partially explained by shared CV risk factors and inflammation.

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Authors: Grenon, S. M., Vittinghoff, E., Owens, C. D., Conte, M. S., Whooley, M., & Cohen, B. E.
Affiliations: San Francisco VA Medical Center (US)
University of California, San Francisco (US)
ORCID: Grenon, S Marlene
Vittinghoff, Eric
Owens, Christopher D
Conte, Michael S
Whooley, Mary
Cohen, Beth E
Venue: Vascular Medicine
Publisher: SAGE Publications
Published: 2013-07-08
Volume: 18
Issue: 4
Pages: 176-184
ISSN: 1358-863X (ISSN-L)
1477-0377
DOI: 10.1177/1358863x13493825
PMC: PMC4207208
OpenAlex: W2143326022
Semantic Scholar: 08d4713059ce5163268ed15c032dddebff564a7b
Cited by: 169
References: 43
Citations by year: 2026: 8 · 2025: 21 · 2024: 15 · 2023: 17 · 2022: 18 · 2021: 21 · 2020: 9 · 2019: 14 · 2018: 18 · 2017: 8 · 2016: 8 · 2015: 5 · 2014: 6 · 2013: 1
FWCI: 6.57
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Vascular Medicine (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Heart, Lung, and Blood Institute (K23HL094765, R01HL079235)
National Center for Research Resources (KL2RR024130)
Topics: Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vascular Procedures and Complications
Keywords: peripheral arterial disease, coronary artery disease, cardiovascular events, cardiovascular mortality, inflammation, inflammatory markers, Heart and Soul Study
MeSH terms: Aged, Coronary Artery Disease, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, San Francisco, Time Factors, Biomarkers, Incidence, Multivariate Analysis, Proportional Hazards Models, Disease Progression, Inflammation Mediators, Peripheral Arterial Disease

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Peripheral artery disease and risk of cardiovascular events in patients with coronary artery disease: Insights from the Heart and Soul Study

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