Clinical outcome in patients with peripheral artery disease. Results from a prospective registry (FRENA)

Abstract 

Background

The risk of future cardiovascular events in patients with peripheral artery disease (PAD) is often underestimated.

Patients and methods

FRENA is an ongoing, observational registry of consecutive outpatients with symptomatic PAD, coronary artery disease (CAD) or cerebrovascular disease (CVD). We compared the incidence of major cardiovascular events (i.e., myocardial infarction, ischemic stroke, critical limb ischemia, or cardiovascular death) during a 12-month follow-up period in a series of consecutive outpatients with PAD, CAD or CVD.

Results

As of December 2006, 1265 patients had been enrolled in FRENA who completed the 12-month follow-up. Of these, 417 patients (33%) had PAD, 474 (37%) had CAD, 374 (30%) had CVD. Patients with PAD had an increased incidence of major cardiovascular events per 100 patient-years: 17 (95% CI: 13–22) vs. 7.9 (5.5–11) in those with CAD, or 8.9 (6.1–13) in those with CVD. Compared to patients with CAD or CVD those with PAD had a similar incidence of myocardial infarction or stroke, but a higher incidence of critical limb ischemia, limb amputation and death. This incidence increased with the severity of the symptoms: 8.7 (95% CI: 5.3–13) in patients in Fontaine stage IIa; 25 (95% CI: 16–38) in stage IIb; 26 (95% CI: 13–47) in stage III; 42 (95% CI: 24–67) in stage IV.

Conclusions

Our data confirm a higher incidence of major cardiovascular events for patients with PAD, as well as a correlation of these events with the severity of PAD.

Keywords: Outcome, Peripheral arterial disease, Secondary prevention