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Clinical and prognostic features in asymptomatic and symptomatic patients with arteriosclerosis obliterans

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Author(s): Takashi Kiyanagi | Makoto Hiki | Rie Matsumori | Atsumi Kume | Hiroyuki Daida | Tetsuro Miyazaki | Haruyo Yamashita | Takuma Yoshihara | Kosuke Fukao | Kazunori Shimada | Hiromichi Ohsaka | Eiryu Sai | Kuniaki Hirose | Hiroshi Masuda | Yoshifumi Fukushima

Journal: Advances in Molecular Imaging
ISSN 2161-6728

Volume: 02;
Issue: 01;
Start page: 1;
Date: 2011;
Original page

Keywords: Arteriosclerosis Obliterans | Fontaine Classification | Risk Factor | Mortality | Cardiocerebrovascular Event

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 cli- nical 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 classi-fication severity (P = 0.028). Conclusion: Patients with ASO had overlapping coronary risk factors and a high incidence rate of cardiovascular events. The in-cidence of coronary events was common, especially in symptomatic patients, and the mortality rates after MACCEs were high in accordance with F classifica-tion severity.
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