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Heart Failure More Prevalent in Patients With Peripheral Arterial Disease: Presented at HFSA

By Marvin Ross

TORONTO, ON -- September 16, 2004 -- Peripheral arterial disease (PAD) should be used as a potential risk marker for underlying heart failure (HF), according to data presented here September 13^th at the Heart Failure Society of America 8^th Annual Scientific Meeting.

Rishi G. Anand, MD, Department of Internal Medicine, Louisiana State University Health Sciences Center, School of Medicine, New Orleans, Louisiana, said peripheral arterial disease has emerged as an important risk factor for ischemic cardiac events.

The development of HF represents a late event in the cardiovascular continuum and largely results from the concerted influence of risk factors that mediate atherosclerosis. Since risk markers for HF cluster in individuals with PAD, Dr. Anand and colleagues conducted a meta-analysis to examine the prevalence of HF in this population -- an hypothesis that has not been previously adequately evaluated, he said.

The researchers analyzed all clinical trials completed on PAD from 1966 to July 2003 obtained from a MEDLINE search. Articles were included for data extraction if they reported on the presence of HF or left ventricular dysfunction. Two blinded reviewers extracted demographic data, including prevalence of HF.

Expected prevalence rates of HF to serve as population controls were derived from the age and gender specific National Health and Nutrition Examination Survey (NHANES) epidemiologic database.

Eight investigations out of more than 500 met the final inclusion criteria, for a total of 10,771 evaluable patients. The average age was 67 and the prevalence of HF in patients with PAD was 7.3% (range 5.3%-13.9%) compared with an expected population prevalence of 4.1% (range 3.7%-4.5%). The odds ratio for an increased prevalence of HF among those with PAD was 1.8 (95% CI 1.68-1.94, p<0.001). The number of screened PAD patients needed to detect one HF case was 32 (95% CI 28-38). In comparison, the number of screened patients needed using mammography to detect one case of breast cancer in women 50 years and older is 540.

The presence of PAD, Dr. Anand concluded, is associated with a two-fold increase in the prevalence of heart failure.


[Presentation title: "Is Heart Failure More Prevalent in Patients with Peripheral Arterial Disease? A Systematic Meta-Analysis." Poster 278]

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