Impact of Peripheral Artery Disease on Prognosis in Hospitalized Heart Failure Patients

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Author(s)

    • Nakamura Yuichi
    • Department of Cardiology and Hematology, Fukushima Medical University
    • Sato Takamasa
    • Department of Cardiology and Hematology, Fukushima Medical University
    • Suzuki Satoshi
    • Department of Cardiology and Hematology, Fukushima Medical University|Department of Advanced Cardiac Therapeutics, Fukushima Medical University
    • Sugimoto Koichi
    • Department of Cardiology and Hematology, Fukushima Medical University
    • Suzuki Hitoshi
    • Department of Cardiology and Hematology, Fukushima Medical University
    • Saitoh Shu-ichi
    • Department of Cardiology and Hematology, Fukushima Medical University
    • Takeishi Yasuchika
    • Department of Cardiology and Hematology, Fukushima Medical University|Department of Advanced Cardiac Therapeutics, Fukushima Medical University
    • Kunii Hiroyuki
    • Department of Cardiology and Hematology, Fukushima Medical University
    • Yoshihisa Akiomi
    • Department of Cardiology and Hematology, Fukushima Medical University|Department of Advanced Cardiac Therapeutics, Fukushima Medical University
    • Takiguchi Mai
    • Department of Cardiology and Hematology, Fukushima Medical University
    • Shimizu Takeshi
    • Department of Cardiology and Hematology, Fukushima Medical University
    • Iwaya Shoji
    • Department of Cardiology and Hematology, Fukushima Medical University
    • Owada Takashi
    • Department of Cardiology and Hematology, Fukushima Medical University
    • Abe Satoshi
    • Department of Cardiology and Hematology, Fukushima Medical University

Abstract

<b><i>Background:</i></b>The impact of peripheral artery disease (PAD) on heart failure (HF) prognosis remains unclear.<b><i>Methods and Results:</i></b>A total of 388 consecutive decompensated HF patients were divided into 2 groups based on the presence of PAD: HF with PAD (PAD group, n=101, 26.0%) and HF without PAD (non-PAD group, n=287, 74.0%). We compared clinical features, echocardiographic parameters, cardiopulmonary exercise testing results, laboratory findings, as well as cardiac, non-cardiac, and all-cause mortality between the 2 groups. The PAD group, as compared with the non-PAD group, had (1) higher prevalence of coronary artery disease (40.6 vs. 27.5%, P=0.011) and cerebrovascular disease (34.7 vs. 18.2%, P=0.001); (2) higher tumor necrosis factor-α (1.82 vs. 1.49 pg/ml, P=0.023), C-reactive protein (0.32 vs. 0.19 mg/dl, P=0.045), and troponin T (0.039 vs. 0.021 ng/ml, P=0.019); (3) lower LVEF (42.4 vs. 48.5%, P<0.001); (4) lower peak V̇O<sub>2</sub>(13.4 vs. 15.9 ml·kg<sup>–1</sup>·min<sup>–1</sup>, P=0.001); and (5) higher V̇E/V̇CO<sub>2</sub>slope (38.8 vs. 33.7, P<0.001). On Kaplan-Meier analysis, cardiac, non-cardiac, and all-cause mortality were significantly higher in the PAD group than in the non-PAD group (P<0.05, respectively). On Cox proportional hazard analysis after adjusting for confounding factors, PAD was an independent predictor of cardiac and all-cause mortality (P<0.05, respectively) in HF patients.<b><i>Conclusions:</i></b>PAD was common and an independent predictor of cardiac and all-cause mortality in HF patients. (<i>Circ J</i> 2015; <b>79:</b> 785–793)

Journal

  • Circulation Journal

    Circulation Journal 79(4), 785-793, 2015

    The Japanese Circulation Society

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