4.8: Arterial Stiffness and its Relationship to Mortality in Patients with Peripheral Artery Disease

Abstract

Background and aim

Several studies (1,2) suggest that patients with peripheral artery disease (PAD) show an increase in arterial stiffness, nevertheless the impact on mortality is less documented. (3)

Methods

228 PAD patients mean age (68 ± 9 years) were followed-up for 4,8 ± 2 years. Anthropometric and clinical measurements were collected, ankle-brachial index (ABI) was estimated with standard protocol and hemodynamic parameters (central blood pressure, aortic pulse wave velocity [aPWV], augmentation index [Aix]) were measured using applanation tonometry. Prognostic factors of mortality were identified by Cox proportional hazards regression model.

Results

During follow-up 26 (11,6%) deaths occurred. Among them, 5 (19%) were of cardiovascular origin. The Cox analysis applied to data relative to the third tertile of aPWV (11.4–21.4, m/s), is significant for age, (p = 0.039), smoking history (p = 0.0003) non use of lipid lowering drugs (p = 0.026) and lower height (p = 0.007) but not for aPWV (p = 0.312), Aix (p = 0.075) and ABI (p = 0.305).

Conclusions

The present study provides further insights into the lack of association between large artery stiffness, pressure wave reflections and mortality in PAD patients.