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Peripheral Artery Disease Patients May Benefit More from Aggressive Secondary Prevention than Aneurysm Patients to Improve Survival

2016-07-15Journal article Open access
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dc.contributor.authorUltee, K
dc.contributor.authorHoeks, Sa
dc.contributor.authorBasto Gonçalves, F
dc.contributor.authorBoersma, E
dc.contributor.authorStolker, R
dc.contributor.authorVerhagen, H
dc.contributor.authorRouwet, E
dc.date.accessioned2016-08-22T14:52:14Z
dc.date.available2016-08-22T14:52:14Z
dc.date.issued2016-07-15
dc.description.abstractBACKGROUND AND AIMS: Although it has become clear that aneurysmal and occlusive arterial disease represent two distinct etiologic entities, it is still unknown whether the two vascular pathologies are prognostically different. We aim to assess the long-term vital prognosis of patients with abdominal aortic aneurysmal disease (AAA) or peripheral artery disease (PAD), focusing on possible differences in survival, prognostic risk profiles and causes of death. METHODS: Patients undergoing elective surgery for isolated AAA or PAD between 2003 and 2011 were retrospectively included. Differences in postoperative survival were determined using Kaplan-Meier and Cox regression analysis. Prognostic risk profiles were also established with Cox regression analysis. RESULTS: 429 and 338 patients were included in the AAA and PAD groups, respectively. AAA patients were older (71.7 vs. 63.3 years, p < 0.001), yet overall survival following surgery did not differ (HR: 1.16, 95% CI: 0.87-1.54). Neither was type of vascular disease associated with postoperative cardiovascular nor cancer-related death. However, in comparison with age- and gender-matched general populations, cardiovascular mortality was higher in PAD than AAA patients (48.3% vs. 17.3%). Survival of AAA and PAD patients was negatively affected by age, history of cancer and renal insufficiency. Additional determinants in the PAD group were diabetes and ischemic heart disease. CONCLUSIONS: Long-term survival after surgery for PAD and AAA is similar. However, overall life expectancy is significantly worse among PAD patients. The contribution of cardiovascular disease towards mortality in PAD patients warrants more aggressive secondary prevention to reduce cardiovascular mortality and improve longevity.pt_PT
dc.identifier.citationAtherosclerosis. 2016 Jul 15;252:147-152pt_PT
dc.identifier.doi10.1016/j.atherosclerosis.2016.07.900pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2559
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHSM CIR VASCpt_PT
dc.subjectAge Factorspt_PT
dc.subjectAortic Aneurysm, Abdominal/complicationspt_PT
dc.subjectAortic Aneurysm, Abdominal/mortalitypt_PT
dc.subjectAortic Aneurysm, Abdominal/surgerypt_PT
dc.subjectCoronary Artery Disease/prevention & controlpt_PT
dc.subjectElective Surgical Procedurespt_PT
dc.subjectKaplan-Meier Estimate
dc.subjectMyocardial Ischemia/pathology
dc.subjectPeripheral Arterial Disease/complications
dc.subjectPeripheral Arterial Disease/mortality
dc.subjectPeripheral Arterial Disease/surgery
dc.subjectPostoperative Period
dc.subjectProportional Hazards Models
dc.subjectPrognosis
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectSecondary Prevention
dc.subjectSex Factors
dc.subjectTreatment Outcome
dc.titlePeripheral Artery Disease Patients May Benefit More from Aggressive Secondary Prevention than Aneurysm Patients to Improve Survivalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage152pt_PT
oaire.citation.startPage147pt_PT
oaire.citation.titleAtherosclerosispt_PT
oaire.citation.volume252pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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