Risk for Cardiac Event Found to Be Greater in PAD vs CAD

The risk for a cardiac event was found to be greater in patients with peripheral artery disease (PAD) vs coronary artery disease (CAD), according to a study published in Journal of Cardiopulmonary Rehabilitation and Prevention.

In this retrospective study, researchers conducted cardiopulmonary assessment, and gathered demographic and anthropometric data for consecutive patients enrolling in a cardiac rehabilitation program (n=9701; n=9179 with CAD; n=143 with PAD; n=379 with CAD and PAD) between January 2006 and December 2017.

Compared with participants with CAD, patients with PAD and with PAD plus CAD were older (62.5±11.1 vs 67.9±11.4 and 69.2±9.8, respectively; P <.001), had higher resting systolic blood pressure (124.5±17.1 vs 130.0±17.2 and 131.6±17.5 mm Hg, respectively; P <.001), had lower cardiorespiratory fitness (19.7±6.3 vs 15.6±4.8 and 15±4.5 mL/kg/min, respectively; P <.01); were more likely to have diabetes (25% vs 35% and 41%, respectively; P <.01); had more abdominal obesity (39% vs 54% and 51%, respectively; P < 01); and were initially prescribed lower-intensity exercise (84.4±14.1 vs 74.1±15.7 and 70.0±14.6 m/min exercise pace, respectively; P <.01).

Study limitations include the use of a standard V0_2peak to assess PAD, rather than the Gardner-Skinner protocol, and a lack of routine measurement of ankle brachial index.

“Patients diagnosed with PAD or [PAD plus CAD] who participated in standard care [cardiac rehabilitation] have an elevated risk profile (older age, higher resting blood pressure, lower V0_2peak) for a repeat or first cardiac event compared with participants with CAD,” the researchers concluded. “Furthermore, patients with PAD have significantly lower baseline V0_2peak and a higher [percentage] of comorbidities, including atrial fibrillation, cancer, diabetes, renal disease, and stroke, than patients with CAD. Considering the impact [cardiac rehabilitation] can have on improving health outcomes and V0_2peak, [cardiac rehabilitation] should be considered a component of care for patients with PAD.”

Reference

Nguyen CH, Marzolini S, Oh P, Thomas SG. Entering cardiac rehabilitation with peripheral artery disease: A retrospective comparison to coronary artery disease [published online January 2, 2020]. Cardiopulm Rehabil Prev. doi: 10.1097/HCR.0000000000000475