Risk factors of adverse cardiovascular prognosis in patients with peripheral artery disease

Abstract

Aim. To prospectively study the prevalence and clinical manifestations of the risk factors (RFs) of adverse cardiovascular prognosis in patients with peripheral artery disease (PAD) of varied severity.
Material and methods. The study included 78 patients with Stage 2-4 PAD, aged 38-70 years. The following cardiovascular RFs were analysed, using standard clinical, laboratory, and instrumental methods: arterial hypertension (AH), smoking, family history of premature coronary heart disease (CHD), hypercholesterolemia (HCH), disturbed carbohydrate metabolism, low physical inactivity (LPA), heart rate (HR) >70 beats per minute (bpm), abdominal obesity (AO), metabolic syndrome (MS), blood hypercoagulation, and elevated levels of high-sensitivity C-reactive protein (hsCRP).
Results. In most PAD patients, atherosclerosis had multiple localization (75,0%). There was an association between duration of the disease, its severity, and disabled status. The prevalence of cardiovascular RFs was high: 94,0% for HCH, 90,0% for AH, 89,0% for smoking, 58,0% for premature CHD in family history, 81,0% for hyperfibrinogenemia, 73,0% for HR >70 bpm, 73,0% for MS, 73,0% for increased pulse blood pressure, 67,0% for overweight, 77,0% for LPA, and 53,0% for elevated hsCRP levels. The one-year follow-up data demonstrated a high incidence of cardiac (30,0%) and vascular (28,0%) complications. The three most important RFs of adverse cardiovascular prognosis included AH progression, CHD, and intermittent claudication.
Conclusion. The high prevalence of multifocal atherosclerosis (approximately 75%), AH, CHD, and MS in PAD patients warrants the need for early detection and effective control of modifiable RFs, in order to prevent the progression of the disease and the development of cardiovascular complications.