Peripheral Artery Disease Predicts Cardiac Death in Patients With Diabetes

PAD is common in patients with type 2 diabetes and predicts cardiac death, supporting the role of regular screening for PAD in these patients. A group of researchers led by Professor Paul Norman of Fremantle Hospital, Australia, examined the relationship between peripheral artery disease (PAD) related to type 2 diabetes and the risk of cardiac death. Between 1993 and 1996, a total of 1,294 patients were enrolled in the Fremantle Diabetes Study, a prospective, community-based observational study. Of these patients, 531 had valid data collected at baseline and 5 or more subsequent consecutive annual reviews. A range of clinical and biochemical factors were assessed, including the ankle/brachial index (ABI). For this study, PAD was defined as an ABI 0.90 or less at 2 consecutive reviews, or any PAD-related amputation of the lower extremities.

The researchers found that an ABI 0.90 or less was independently associated with an increased risk of cardiac death of 67%. Overall, the prevalence of PAD at baseline was 13.6%. The incidence of new PAD was 3.7 per 100 patient-years. The prevalence and incidence were associated with increasing age, systolic blood pressure, total serum cholesterol, and smoking. Management of risk factors for PAD improved during follow-up but remained suboptimal.

The researchers concluded that PAD was common in patients with type 2 diabetes and predicted cardiac death, supporting the role of regular screening for PAD in these patients.
Diabetes Care 2006;29:575-80

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