PAD Plus Polyvascular Disease Increases the Risk for MACEs

Individuals with polyvascular disease have an increased risk for major adverse cardiac events and lower-extremity revascularization compared with individuals with peripheral artery disease (PAD) alone, according to new research.

The finding comes from a post-hoc secondary analysis of the international Examining Use of Ticagrelor in Peripheral Artery Disease (EUCLID) trial, in which participants had been randomly assigned either ticagrelor, 90 mg, twice daily, or clopidogrel, 75 mg, once daily.

IF YOU LIKE THIS, READ MORE...

Peripheral Artery Disease Influences Outcomes in Patients with Heart Failure

Mortality Risk Is High in Older Ischemic Heart Disease Patients

The trial was held from December 31, 2012, to March 7, 2014, while the post-hoc analysis was performed from June 1, 2017, to February 5, 2018, on 13,885 participants.

At baseline, 56.2% of participants had PAD alone, 19% had both PAD and coronary artery disease (CAD), 14.8% had both PAD and cerebrovascular disease (CBD), and 10% had all 3 diseases.

With this post-hoc secondary analysis, the researchers determined that, compared with patients with isolated PAD, the adjusted hazard ratios for major adverse cardiac events were 1.34 for the PAD and CBD group; 1.65 for the PAD and CAD group; and 1.99 for the PAD, CAD, and CBD group.

The adjusted hazard ratios for lower-extremity revascularization within the same 3 groups were 1.17, 1.17, and 1.34, respectively.

Meanwhile, the researchers found no clear increased risk of acute limb ischemia, major amputation, or thrombolysis in myocardial infarction major bleeding associated with polyvascular disease.

“These data highlight the increased risk of CAD and [CBD] among patients with PAD and the need to identify potent preventive antithrombotic therapies,” the researchers concluded.

—Colleen Murphy

Reference:

Gutierrez JA, Mulder H, Jones WS, et al. Polyvascular disease and risk of major adverse cardiovascular events in peripheral artery disease: a secondary analysis of the EUCLID trial. JAMA Netw Open. 2018;1(7):e185239. doi:10.1001/jamanetworkopen.2018.5239.