TITLE:
Clinical and prognostic features in asymptomatic and symptomatic patients with arteriosclerosis obliterans
AUTHORS:
Hiromichi Ohsaka, Kazunori Shimada, Kosuke Fukao, Eiryu Sai, Yoshifumi Fukushima, Hiroshi Masuda, Kuniaki Hirose, Takuma Yoshihara, Rie Matsumori, Makoto Hiki, Takashi Kiyanagi, Atsumi Kume, Haruyo Yamashita, Tetsuro Miyazaki, Hiroyuki Daida
KEYWORDS:
Arteriosclerosis Obliterans; Fontaine Classification; Risk Factor; Mortality; Cardiocerebrovascular Event
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.2 No.1,
December
31,
2011
ABSTRACT: Background: Patients with arteriosclerosis obliterans (ASO) often have co-existing atherosclerotic diseases. The purpose of this study was to examine the clinical features of patients with ASO, including the overlap of atherosclerotic risk factors, characteristics of car-diovascular events, and clinical prognosis. Method: We enrolled 205 consecutive patients who had ankle brachial index (ABI) of ?0.9 between January 2008 and December 2009. Fontaine (F) classification and clinical background were evaluated and clinical events including mortality and major adverse cardiocerebro-vascular events (MACCEs) were determined. Results: There was a high prevalence of each risk factor. Sixty- five percent of subjects had three or more of the four overlapping risk factors, including hypertension, dia- betes, dyslipidemia, and smoking. After a maximum follow-up of 800 days, the incidence of MACCEs and mortality was 46% and 10%, respectively. We divided the patients into two groups according to the presence of ASO symptoms (F1 and F2-4) and compared the incidence of events. The incidence of MACCEs and mortality in the F2-4 group was significantly higher than that in the F1 group (P = 0.048, P = 0.044, respectively). After excluding lower extremity revascularization, coronary artery disease was a common cause of MACCEs, and the mortality rates after MACCEs increased in a stepwise manner according to F classification severity (P = 0.028). Conclusion: Patients with ASO had overlapping coronary risk factors and a high incidence rate of cardiovascular events. The incidence of coronary events was common, especially in symptomatic patients, and the mortality rates after MACCEs were high in accordance with F classification severity.