Peripheral arterial disease could predict life or death in heart patients

A growing health problem affecting older Americans puts them at higher risk for dying after heart surgery and other interventional procedures, such as heart catheterizations, according to findings published in the current edition of the Journal of the American College of Cardiology and co-authored by two leading University of Kentucky cardiologists.

The study analyzed the results of eight major research trials involving nearly 20,000 patients who underwent interventional heart procedures, such as balloon angioplasty or stent placement. Patients with peripheral arterial disease (PAD), which mainly includes blockages in leg arteries, were found to be more than twice as likely to die within a week after interventional heart procedures compared with patients free of PAD. This doubling in mortality rates persisted at 30-day and later follow-up. At one year following the heart procedure, 5 percent of patients with PAD had died versus 2.1 percent of patients without PAD. However, while nearly half of Americans 65 or older are expected to have the condition by 2050, only a quarter of PAD patients presently receive treatment. Further, patients with PAD undergoing heart interventions were also more at risk for other complications, including blood clots and bleeding requiring a transfusion.

The study was authored by 13 internationally recognized cardiology researchers, including Dr. David J. Moliterno, Gill Heart Institute medical director and professor and chief of cardiovascular medicine in the UK College of Medicine Department of Internal Medicine, and Dr. Steven R. Steinhubl, associate professor and director of cardiovascular education and clinical research at UK.

"Peripheral arterial disease is prevalent in Kentucky and throughout much of the United States, yet it is strikingly under diagnosed and certainly under treated. It is undeniably easy to ask patients if their legs cramp when they walk, and if so to take a blood pressure recording in not only their arms but also their legs. These steps could be life-saving," Moliterno said.

While the study does not indicate that patients with PAD should avoid interventional procedures, it is a strong reminder that extra precaution should be taken when treating these patients.