Risk of AF and Stroke Increased in Patients with PAD
Journal Wrap | Patients with peripheral artery disease (PAD) are at increased risk of atrial fibrillation (AF) and stroke, but the presence of AF does not appear to mediate the risk of stroke in this population. Those were the primary findings of a study conducted by Wesley T. O’Neal, MD, MPH, and colleagues. The study included 6,568 participants enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA); mean age was 62 years, 53% were women, and 62% were non-white.
Of the total study population, 12% (n = 774) had PAD at baseline. During follow-up (mean, 8.5 years), 4.6% (n = 301) developed AF and 2.1% (n = 140) had a stroke. Following adjustment for sociodemographics, cardiovascular risk factors, and potential confounders, there was an association of PAD with an increased risk of AF (HR = 1.5; 95% CI, 1.1-2.0). In a similarly adjusted model, PAD patients were at increased risk of developing stroke (HR = 1.7; 95% CI, 1.1-2.5). When AF was included as a time-dependent covariate, there was no change in the risk of stroke (HR = 1.7; 95% CI, 1.1-2.5).
“PAD is associated with an increased risk of AF and stroke in MESA. Potentially, the relationship between PAD and stroke is not mediated by AF, ” the researchers said.
Geoffrey D. Barnes, MD, cited the study for Cardiosource.org. “This study serves as a reminder that atherosclerosis is a diffuse disease. Clinicians should consider evaluating all vascular beds as potential targets of atherosclerosis in PAD patients,” he said.
O’Neal WT, Efird JT, Nazarian S, et al. J Am Heart Assoc. 2014;doi:10.1161/JAHA.114.001270.
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