(Circulation. 2006;114:II_378.)
© 2006 American Heart Association, Inc.
Prevalence and Prognosis in PVD |
Abstract 1903: Prevalence and Clinical Characteristics of Peripheral Artery Disease in Patients with Type 2 Diabetes and CAD Enrolled in The BARI 2D Trial
1 Lahey Clinic, Burlington, MA
2 Brown Med Sch, Providence, RI
3 Univ of Pittsburgh, Pittsburgh, PA
4 Northwestern Univ Feinberg Sch of Medicine, Chicago, IL
5 Lahey Clinic, Burlington, MA
6 Univ of Pittsburgh, Pittsburgh, PA
7 Univ of Manchester, Manchester, United Kingdom
8 Lahey Clinic, Burlington, MA
9 Northwestern Univ, Chicago, IL
10 Lahey Clinic, Burlington, MA
Introduction: Peripheral arterial disease (PAD) is a risk factor for CAD events and foot complications in patients with type 2 diabetes (D). The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial recently completed enrollment of 2368 patients with type 2 diabetes (D) and CAD. The exact prevalence and nature of PAD in D patients with CAD is not well established.
Method: We determined the prevalence of PAD using Ankle-Brachial Index (ABI) in 2232 BARI 2D patients. ABIs were classified as; normal 0.91–1.3, low <0.9 or high >1.3.
Results: 1468 or 66% had a normal ABI. Low ABI was found in 430 or 19% and a high ABI in 180 or 8%. Compared to patients with a normal ABI, those with a low ABI were more likely to be female (38.4 vs. 28.5%, p<0.0001), older (63.4 vs. 61.8 years, p=0.001), African American (27.7 vs 15.4%, p<0001), have longer duration of known diabetes (11.8 vs. 10.3 years, p=0.002), and have a higher HbA1c (7.9 vs.7.7%, p=0.04). Sedentary lifestyle, current smoking, presence of non-coronary artery disease, greater extent of CAD, a history of CHF and HTN were also more common in the low ABI group. 292 or 68% of the 430 in the low ABI group were asymptomatic ("silent PAD"). This group had less peripheral neuropathy (27.9 vs. 58.1%, p<0.0001), lower rate of smoking (15.1 vs 31.2, p=0.0001) and carotid artery disease (8.2 vs 27.5%, p<0.0001).
Conclusion: ABIs in patients with D and CAD identify a significant number of patients with PAD most of whom are symptom-free. As PAD is a risk factor associated with a poor prognosis, additional measures may need to be devised to reduce cardiovascular events in these patients.
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