Diehm N, Shang A, Silvestro A, Do DD, Dick F, Schmidli J, Mahler F, Baumgartner I, et al.
European journal of vascular and endovascular surgery : the official journal of the European So.... Date of publication 2006 Jan 1;volume 31(1):59-63.
1. Eur J Vasc Endovasc Surg. 2006 Jan;31(1):59-63. Epub 2005 Nov 2.
Association of cardiovascular risk factors with pattern of lower limb
atherosclerosis in 2659 patients undergoing angioplasty.
Diehm N(1), Shang A, Silvestro A, Do DD, Dick F, Schmidli J, Mahler F,
Baumgartner I.
Author information:
(1)Division of Angiology, Swiss Cardiovascular Center, Inselspital, University
Hospital of Bern, Bern, Switzerland.
OBJECTIVES: Aim of this study is to correlate distribution pattern of lower limb
atherosclerosis with cardiovascular risk factor profile of patients with
peripheral arterial occlusive disease (PAD).
PATIENTS AND METHODS: Analysis is based on a consecutive series of 2659 patients
(1583 men, 1076 women, 70+/-11 years) with chronic PAD of atherosclerotic origin
undergoing primary endovascular treatment of lower extremity arteries. Pattern of
atherosclerosis was grouped into iliac (n=1166), femoropopliteal (n=2151) and
infrageniculate (n=888) disease defined according to target lesions treated. A
multivariable multinomial logistic regression analysis was performed to assess
relation with age, gender and classical cardiovascular risk factors (diabetes
mellitus, arterial hypertension, hypercholesterolemia, cigarette smoking) using
femoropopliteal disease as reference.
RESULTS: Iliac disease was associated with younger age (RRR 0.95 per year of age,
95%-CI 0.94-0.96, p<0.001), male gender (RRR 1.32, 95%-CI 1.09-1.59, p=0.004) and
cigarette smoking (RRR 2.02, 95%-CI 1.68-2.42, p<0.001). Infrageniculate disease
was associated with higher age (RRR 1.02, 95%-CI 1.01-1.02, p<0.001), male gender
(RRR 1.23, 95%-CI 1.06-1.41, p=0.005) and diabetes mellitus (RRR 1.68, 95%-CI
1.47-1.92, p<0.001). Hypercholesterolemia was less prevalent in patients with
lesions below the knee (RRR 0.82, 95%-CI 0.71-0.94, p=0.006), whereas no distinct
pattern was apparent related to arterial hypertension.
CONCLUSION: Clinical phenotype of peripheral atherosclerosis varies with
prevalence of cardiovascular risk factors suggesting differences in mechanisms
involved in iliac as compared with infrageniculate lesions. Identification of
molecular mechanism might have influence on future therapeutic strategies in PAD
patients.
DOI: 10.1016/j.ejvs.2005.09.006
PMID: 16269257 [Indexed for MEDLINE]
