Long-Term Prognosis and Predictive Risk Factors for Polyvascular Disease in Patients with Peripheral Arterial Disease

Background: The aim of the current study was to assess fifteen-year life expectancy, cardiovascular events, fate of the limb, and risk factors with or without polyvascular disease in patients with Peripheral Arterial Disease (PAD). Methods: We conducted a prospective cohort study in 1019 PAD patients. The endpoints were Cardiovascular or Cerebrovascular Death (CCVD), All-Cause Death (ACD), Major Adverse Cardiovascular Events (MACE), and Cardiovascular and/or Limb Events (CVLE). Results: The patients who died were 539 (52.9%) during follow-up periods. The rate of CCVD was 50.5% (n = 272). In multiple regression analysis, the number of affected arteries had correlations with estimated Glomerular Filtration Rate (eGFR), HDL-cholesterol, Ankle Brachial Pressure Index (ABI), and diabetes (p < 0.05). In multiple logistic analysis, PAD with Cerebrovascular Disease (CVD) was correlated with older age, ABI, eGFR, and atrial fibrillation (p < 0.05);PAD with Coronary Heart Disease (CHD) was correlated with younger age, eGFR, HDL-cholesterol, LDL- cholesterol, and diabetes (p < 0.05);and triple vascular disease (PAD with CVD and CHD) was correlated with ABI, eGFR, HDL-cholesterol, and diabetes (p < 0.05). The number of affected arteries had significant correlations with CCVD, ACD, MACE, and CVLE (p < 0.05). In Cox multivariate analyses, age, Critical Limb Ischemia (CLI), eGFR, albumin, C-Reactive Protein (CRP), Body Mass Index (BMI), CVD, and CHD were related to CCVD (p < 0.05);age, albumin, eGFR, CRP, BMI, CLI, and CVD were associated with ACD (p < 0.05);age, albumin, eGFR, CRP, CLI, CHD, and diabetes were associated with MACE (p < 0.05);age, ABI, albumin, eGFR, CRP, CLI, CHD, and diabetes were related to CVLE (p < 0.05). Statins improved all outcomes (p < 0.05). Conclusions: Polyvascular disease was independently associated with fifteen-year mortality, cardiovascular events, and the fate of the limb with diverse risk factors in PAD patients.