Prevalence of diabetes and comorbidities in symptomatic peripheral artery disease

Aim of the study to determine the prevalence of vascular risk factors in patients with symptomatic peripheral artery disease (PAD), the correlation with disease progression, and the effects of treatment on the clinical outcomes. Methods Preliminary results are presented, regarding a selected population of 182 patients (127M, 55F) with symptomatic PAD candidate to revascularization, aged 68.7 ± 4.3. Patients underwent clinical examination and blood analysis, self-reported non diabetic patients underwent OGTT. Patients were analyzed according to presence and severity of clinical symptoms, localization of arterial stenosis, comorbidities and cardiovascular risk factors. Results Based on clinical symptoms, 34 patients (18.7%) were classified on stage IV, 14 (7.6%) on stage III, 48 (26.3%) on stage IIb, 80 (43.9%) on stage IIa. Bilateral obstruction were detected in 93 patients (51%). On the basis of clinical examination the main risk factors were smoke (77,4%, active in 30,7% of patients), hypertension (78.5%), diabetes (56.5%), hyperdyslipidemia (56%). OGTT revealed an higher prevalence of patients with impaired glucose metabolism (diabetes in 62%, IGT in 8.2% of patients). Comorbidity was detected in most patients, namely coronary artery disease (36.7%), previous MI (17%), heart failure (10,9%), carotid stenosis (32.9%), previous cerebrovascular events (9.3%), atrial fibrillation (14.8%), renal failure (19.2%). In our study, patients with all stages PAD showed mean BMI of 26.4 ± 4.1 Kg/m2, suboptimal blood pressure control (mean systolic values at baseline 153 ± 19 mmHg), abnormal levels of HbA1c (6.7 ± 1.4 %), CRP (11.6 ± 6 mg/dl), microalbuminuria (140 mg/24h). Discussion and conclusions In our study subjects with symptomatic PAD revealed a very high prevalence of vascular risk factors and cardiovascular comorbidity. After screening with OGTT, we found a large number of patients with undiagnosed abnormality of glucose metabolism. We suggest that in patients with PAD a complete evaluation of abnormalities of glucose metabolism might prevent progression of PAD and improve clinical outcomes.