Prevalence and Outcomes of Undiagnosed Peripheral Arterial Disease Among High Risk Patients in Australia: An Australian REACH Sub-Study

© 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Background: Compared with other manifestations of cardiovascular disease, peripheral arterial disease (PAD) is under-diagnosed. This study aims to invest...

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Main Authors: Si, Si, Golledge, J., Norman, P., Nelson, M., Chew, D., Ademi, Z., Bhatt, D., Steg, G., Reid, Christopher
Format: Journal Article
Published: Elsevier 2018
Online Access:http://hdl.handle.net/20.500.11937/68607
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author Si, Si
Golledge, J.
Norman, P.
Nelson, M.
Chew, D.
Ademi, Z.
Bhatt, D.
Steg, G.
Reid, Christopher
author_facet Si, Si
Golledge, J.
Norman, P.
Nelson, M.
Chew, D.
Ademi, Z.
Bhatt, D.
Steg, G.
Reid, Christopher
author_sort Si, Si
building Curtin Institutional Repository
collection Online Access
description © 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Background: Compared with other manifestations of cardiovascular disease, peripheral arterial disease (PAD) is under-diagnosed. This study aims to investigate the prevalence, risk profile and cardiovascular outcomes of undiagnosed PAD in Australian general practices. Method: A sub-study of the Australian Reduction of Atherothrombosis for Continued Health (REACH) Registry, a prospective cohort study of patients at high risk of atherothrombosis recruited from Australian general practices. Eligible patients for this study had no previous clinical diagnosis of PAD and had an ankle-brachial index (ABI) =1.4 at recruitment. Results: Peripheral arterial disease was undiagnosed in 34% Australian REACH participants, 28% patients had low ABI (ABI < 0.9) and 11% had intermittent claudication (IC) based on responses to the Edinburgh Claudication Questionnaire (ECQ). We found no significant differences in risk factor control between patient with or without PAD. Intermittent claudication patients had higher risks of non-fatal cardiovascular events and PAD interventions at one year, whereas all-cause mortality rate was higher among patients with ABI < 0.9, especially in those who also reported IC. Finally, an ABI < 0.9, together with poorly controlled risk factors were independent predictors of incident IC at one year. Conclusions: This study suggests a high rate of undiagnosed PAD among high risk patients in Australian primary health care. These patients are at high risk of events and therefore would potentially benefit from better secondary prevention measures.
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spelling curtin-20.500.11937-686072018-09-05T07:50:30Z Prevalence and Outcomes of Undiagnosed Peripheral Arterial Disease Among High Risk Patients in Australia: An Australian REACH Sub-Study Si, Si Golledge, J. Norman, P. Nelson, M. Chew, D. Ademi, Z. Bhatt, D. Steg, G. Reid, Christopher © 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Background: Compared with other manifestations of cardiovascular disease, peripheral arterial disease (PAD) is under-diagnosed. This study aims to investigate the prevalence, risk profile and cardiovascular outcomes of undiagnosed PAD in Australian general practices. Method: A sub-study of the Australian Reduction of Atherothrombosis for Continued Health (REACH) Registry, a prospective cohort study of patients at high risk of atherothrombosis recruited from Australian general practices. Eligible patients for this study had no previous clinical diagnosis of PAD and had an ankle-brachial index (ABI) =1.4 at recruitment. Results: Peripheral arterial disease was undiagnosed in 34% Australian REACH participants, 28% patients had low ABI (ABI < 0.9) and 11% had intermittent claudication (IC) based on responses to the Edinburgh Claudication Questionnaire (ECQ). We found no significant differences in risk factor control between patient with or without PAD. Intermittent claudication patients had higher risks of non-fatal cardiovascular events and PAD interventions at one year, whereas all-cause mortality rate was higher among patients with ABI < 0.9, especially in those who also reported IC. Finally, an ABI < 0.9, together with poorly controlled risk factors were independent predictors of incident IC at one year. Conclusions: This study suggests a high rate of undiagnosed PAD among high risk patients in Australian primary health care. These patients are at high risk of events and therefore would potentially benefit from better secondary prevention measures. 2018 Journal Article http://hdl.handle.net/20.500.11937/68607 10.1016/j.hlc.2018.04.292 Elsevier restricted
spellingShingle Si, Si
Golledge, J.
Norman, P.
Nelson, M.
Chew, D.
Ademi, Z.
Bhatt, D.
Steg, G.
Reid, Christopher
Prevalence and Outcomes of Undiagnosed Peripheral Arterial Disease Among High Risk Patients in Australia: An Australian REACH Sub-Study
title Prevalence and Outcomes of Undiagnosed Peripheral Arterial Disease Among High Risk Patients in Australia: An Australian REACH Sub-Study
title_full Prevalence and Outcomes of Undiagnosed Peripheral Arterial Disease Among High Risk Patients in Australia: An Australian REACH Sub-Study
title_fullStr Prevalence and Outcomes of Undiagnosed Peripheral Arterial Disease Among High Risk Patients in Australia: An Australian REACH Sub-Study
title_full_unstemmed Prevalence and Outcomes of Undiagnosed Peripheral Arterial Disease Among High Risk Patients in Australia: An Australian REACH Sub-Study
title_short Prevalence and Outcomes of Undiagnosed Peripheral Arterial Disease Among High Risk Patients in Australia: An Australian REACH Sub-Study
title_sort prevalence and outcomes of undiagnosed peripheral arterial disease among high risk patients in australia: an australian reach sub-study
url http://hdl.handle.net/20.500.11937/68607