Control of modifiable risk factors and major adverse cardiovascular events in people with peripheral artery disease and diabetes

Table 1 Characteristics of include participants (n = 424)

Characteristic	Value
Age (median years, IQR)	69 (63-76)
Gender (male, %)	311 (73.3)
Aboriginal or Torres strait islander, n (%)	19 (4.5)
Presenting problem, n (%)
Carotid artery disease	63 (14.9)
Aortic or peripheral aneurysm	121 (28.5)
Lower limb ischemia	240 (56.6)
Smoking status, n (%)
Current	101 (23.8)
Former	211 (49.8)
Never	111 (26.2)
Missing	1 (0.2)
Medications, n (%)
Aspirin	278 (65.6)
Other anti-platelet	84 (19.8)
Statins	324 (76.4)
Metformin	251 (59.2)
Other oral hypoglycemics	154 (36.3)
Insulin	98 (23.1)
Co-morbidities, n (%)
Ischemic heart disease (IHD)	201 (47.4)
Stroke	47 (11.1)
Vitals (median, IQR)
Glycated hemoglobin (HbA1c) (%)	6.9 (6.2-7.8)
Low-density lipoprotein (LDL)-c (mmol/L)	2 (1.5-2.6)
Systolic blood pressure (mmHg)	139 (125-151)
C-reactive protein (mg/L)1	2.7 (1.0-6.0)

¹C-reactive protein data is missing from 37 participants.

Table 2 Association of peripheral artery disease-medical score with baseline characteristics

Risk factors	PAD-medical score				P value
	< 3.0 (n = 106)	3-3.9 (n = 145)	4.0-4.9 (n = 140)	5.0 (n = 33)
Age	65 (57-73)	70 (64-77)	69 (64-77)	70 (66-76)	0.002b
Male sex	67 (63.2)	110 (75.9)	110 (78.6)	24 (72.7)	0.046a
Aboriginal or Torres Strait Islander	3 (2.8)	9 (6.2)	4 (2.9)	3 (9.1)	0.242
Presenting problem					0.043a
Carotid artery disease	12 (11.3)	19 (13.1)	27 (19.3)	5 (15.2)
Aortic or peripheral aneurysm	22 (20.8)	45 (31.0)	42 (30.0)	12 (36.4)
Lower limb ischemia	72 (67.9)	81 (55.9)	71 (50.7)	16 (48.5)
Smoking status					< 0.001c
Current	55 (51.9)	41 (28.3)	5 (3.6)	0
Former	28 (26.4)	62 (42.8)	100 (71.4)	21 (63.6)
Never	22 (20.8)	42 (29.0)	35 (25.0)	12 (36.4)
IHD	38 (35.8)	64 (44.1)	75 (53.6)	24 (72.7)	0.001b
Stroke	14 (13.2)	12 (8.3)	17 (12.1)	4 (12.1)	0.606
Medications
Aspirin	34 (32.1)	96 (66.2)	118 (84.3)	30 (90.9)	< 0.001c
Other anti-platelet	11 (10.4)	25 (17.2)	41 (29.3)	7 (21.2)	0.002b
Statins	58 (54.7)	115 (79.3)	121 (86.4)	30 (90.9)	< 0.001c
Metformin	60 (56.6)	87 (60.0)	83 (59.3)	21 (63.6)	0.896
Other oral hypoglycemics	39 (36.8)	58 (40.0)	45 (32.1)	12 (36.4)	0.591
Insulin	26 (24.5)	35 (24.1)	33 (23.6)	4 (12.1)	0.482
HbA1c (%)	7.4 (6.8-8.7)	7.0 (6.5-7.7)	6.6 (6.0-7.6)	6.1 (5.9-6.4)	< 0.001c
HDL-c (mmol/L)	1.1 (0.9-1.3)	1.1(0.9-1.3)	1.1(0.9-1.2)	0.9(0.8-1.2)	0.133
LDL-c (mmol/L)	2.60 (2.20-3.40)	2.10 (1.70-2.70)	1.60 (1.30-2.00)	1.34 (1.20-1.60)	< 0.001c
SBP (mmHg)	150 (139-163)	139 (125-151)	135 (122-150)	126 (120-131)	< 0.001c
C-reactive protein (mg/L)	3.0 (1.9-7.5)1	2.0 (1.0-5.0)2	3.0 (1.0-5.6)3	2.1 (0.9-5.0)4	0.082
Major cardiovascular events	23 (21.7)	27 (18.6)	32 (22.9)	7 (21.2)	0.845

^aP < 0.05.

^bP < 0.01.

^cP< 0.001.

Data are presented as number (percentage) or median (interquartile range). C-reactive protein data is missing from 9¹, 15², 8³ and 5⁴ participants. PAD: Peripheral artery disease; IHD: Ischemic heart disease; HbA1c: Hemoglobin A1c; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; SBP: Systolic blood pressure.

Table 3 Association of peripheral artery disease-medical score and components with risk of major adverse cardiovascular events

Risk factor measure	HR	95%CI	P value
PAD-medical score	0.79	0.63 to 0.98	0.030a
LDL-C score	0.80	0.46 to 1.39	0.436
HbA1c score	0.94	0.48 to 1.83	0.853
Blood pressure score	0.59	0.30 to 1.16	0.125
Smoking abstinence	0.61	0.38 to 0.97	0.036a
Any anti-platelet	0.81	0.49 to 1.34	0.411

^aP < 0.05. Adjusted for age, sex, ischemic heart disease and stroke. PAD: Peripheral artery disease; LDL: Low-density lipoprotein; HbA1c: Hemoglobin A1c.