Author + information
- Received April 9, 2020
- Accepted May 15, 2020
- Published online July 13, 2020.
- Lisandro D. Colantonio, MD, PhDa,∗ (, )@lcolantonio,
- Demetria Hubbard, MSPHa,
- Keri L. Monda, PhDb,
- Katherine E. Mues, PhD, MPHb,
- Lei Huang, MS, PhDa,
- Yuling Dai, MS, MSPHa,
- Elizabeth A. Jackson, MD, MPHc,
- Todd M. Brown, MD, MSPHc,
- Robert S. Rosenson, MDd,
- Mark Woodward, PhDe,f,g,
- Paul Muntner, PhDa and
- Michael E. Farkouh, MD, MSch
- aDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
- bCenter for Observational Research, Amgen Inc., Thousand Oaks, California
- cDepartment of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- dMount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York
- eThe George Institute for Global Health, University of Oxford, Oxford, United Kingdom
- fThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- gDepartment of Epidemiology, Johns Hopkins University, Baltimore, Maryland
- hPeter Munk Cardiac Centre, University of Toronto and Heart and Stroke Richard Lewar Centre of Excellence, Toronto, Ontario, Canada
- ↵∗Address for correspondence:
Dr. Lisandro D. Colantonio, Department of Epidemiology, University of Alabama at Birmingham, 1720 2nd Avenue South, RPHB 527C. Birmingham, Alabama 35294-0013.
Background Peripheral artery disease (PAD) is associated with increased risk for atherosclerotic cardiovascular disease (ASCVD) events.
Objectives The goal of this study was to compare the risk for ASCVD events and the use of statins among patients with PAD versus those with coronary heart disease (CHD) or cerebrovascular disease.
Methods The authors conducted a retrospective cohort study of adults age ≥19 years with commercial or Medicare health insurance who had a history of PAD, CHD, or cerebrovascular disease on December 31, 2014. Patients were followed for ASCVD events comprising CHD, cerebrovascular disease, and PAD events until December 31, 2017.
Results Among 943,232 patients included in the analysis, the age-standardized ASCVD event rate per 1,000 person-years for those with a history of 1, 2, and 3 conditions including PAD, CHD, and cerebrovascular disease was 40.8 (95% confidence interval [CI]: 40.3 to 41.3), 68.9 (95% CI: 67.9 to 70.0), and 119.5 (95% CI: 117.0 to 122.0), respectively. The ASCVD event rate among patients with PAD only, CHD only, and cerebrovascular disease only was 34.7 (95% CI: 33.2 to 36.2), 42.2 (95% CI: 41.5 to 42.8), and 38.9 (95% CI: 37.6 to 40.1), respectively. Among patients with PAD and CHD, with PAD and cerebrovascular disease, and with CHD and cerebrovascular disease, the ASCVD event rate was 72.8 (95% CI: 71.0 to 74.7), 63.9 (95% CI: 60.6 to 67.4), and 67.9 (95% CI: 66.4 to 69.3), respectively. Statin use was lower in patients with PAD only (33.9%) versus those with cerebrovascular disease only (43.0%) or CHD only (51.7%).
Conclusions Despite having high risk for ASCVD events, patients with PAD were less likely to be taking a statin versus those with CHD or cerebrovascular disease. ASCVD risk-reduction interventions including statin therapy in patients with PAD are warranted.
- cardiovascular disease
- cardiovascular events
- hydroxymethylglutaryl-CoA reductase inhibitors
- secondary prevention
The design and conduct of the study, interpretation of the results, and preparation of the manuscript was supported through a research grant from Amgen, Inc. (Thousand Oaks, California). The academic authors conducted all analyses and maintained the rights to publish this article. Drs. Monda and Mues are Amgen employees and have stock in Amgen. Drs. Jackson, Brown, Rosenson, Woodward, Munter, and Farkouh have received research support from Amgen. Dr. Jackson has received royalties from UpToDate, Inc. Dr. Rosenson has received research support from Akcea, AstraZeneca, The Medicines Company, and Regeneron; has received consulting fees from Amgen, C5, CVS Caremark, Corvidia, and The Medicines Company; has received honoraria from Amgen, Kowa, Pfizer, and Regeneron; has received royalties from UpToDate, Inc.; and has stock in MediMergent, LLC. Dr. Farkouh has received research support from Novo Nordisk. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Deepak L. Bhatt, MD, MPH, served as Guest Editor-in-Chief for this paper.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.
- Received April 9, 2020.
- Accepted May 15, 2020.
- 2020 American College of Cardiology Foundation
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