Carotid-femoral pulse wave velocity was independently associated with an increased risk of peripheral artery disease development or progression (HR 1.17 per 1 m/s increase) in patients with type 2 diabetes.
Cohort (n=681)
No
Do increased carotid intima-media thickness and aortic stiffness predict peripheral artery disease development or progression in patients with type 2 diabetes?
Increased carotid intima-media thickness and aortic stiffness are associated with greater risks of developing or progressing peripheral artery disease in type 2 diabetes, providing prognostic value beyond traditional risk factors.
Effect estimate: HR 1.17 (95% CI 1.05-1.31)
p-value: p=<0.01
BACKGROUND: The prognostic importance of non-traditional risk factors for peripheral artery disease (PAD) development/progression is scarcely studied in diabetes. We investigated if carotid intima-media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) added prognostic information beyond traditional cardiovascular risk markers for PAD outcomes. METHODS: Ankle-brachial index (ABI) was measured at baseline and after a median of 91 months of follow-up in 681 individuals with type 2 diabetes. Multivariate Cox regressions examined the associations between the candidate variables and the outcome. PAD development/progression was defined by a reduction in ABI ≥ 0.15 (to a level < 0.9) or limb revascularization procedures, lower-extremity amputations or death due to PAD. The improvement in risk discrimination was assessed by increases in C-statistics of the models. RESULTS: , 24-h systolic BP (SBP) and mean cumulative office SBP and LDL-cholesterol were associated with PAD development/progression in several models. CIMT and cf-PWV were additionally associated with PAD outcomes, and their inclusion further improved risk discrimination (with C-statistic increases between 0.025 and 0.030). The inclusion of ambulatory 24-h SBP, instead of office SBP, also improved PAD risk discrimination. CONCLUSIONS: Increased CIMT and aortic stiffness are associated with greater risks of developing/progressing PAD, beyond traditional risk factors, in type 2 diabetes.
Cardoso et al. (Sat,) conducted a cohort in Type 2 diabetes (n=681). Carotid-femoral pulse wave velocity (cf-PWV) was evaluated on Peripheral artery disease development or progression (HR 1.17, 95% CI 1.05-1.31, p=<0.01). Carotid-femoral pulse wave velocity was independently associated with an increased risk of peripheral artery disease development or progression (HR 1.17 per 1 m/s increase) in patients with type 2 diabetes.