Peripheral arterial disease and risk of cardiac death in type 2-diabetes

ABSTRACT

The purpose of this study was to determine the natural history of peripheral arterial disease [PAD] complicating type2-diabetics, in particular the influence of PAD on the risk of cardiac death and the adequacy of PAD risk factor management. The study was a prospective study of diabetic patients. The study was performed at Al-Azhar University Hospitals on 15o patients with type 2-diabetes between March 2004 and May 2005, with follow-up period at least 2-years. All patients had a valid data at baseline and three or more subsequent consecutive annual reviews. Assessment consisted of a range of clinical and biochemical variables including the ankle/brachial index [ABI]. PAD was defined as an ABI lower extremity amputation. The prevalence of PAD at study entry was 14% and the incidence of new PAD was 6 per 100 patient-years. Both prevalent and incident PAD was strongly and independently associated with increasing age, systolic blood pressure, total cholesterol and specially smoking. Risk factor management improved but remained suboptimal during follow-up. An ABI of ABI risk of cardiac death. Measurements of the ABI is a simple means of identifying PAD in diabetic patients. PAD is common in diabetic patients and predicts cardiac death. These data further support the role of regular screening for PAD in diabetes so that intensive management of vascular risk factors can be pursued