Multicenter cross-sectional study of asymptomatic peripheral arterial disease among patients with a single previous coronary or cerebrovascular event in the Arabian Gulf

Abstract

Objective:

To evaluate the epidemiology and predictors of asymptomatic peripheral artery disease (PAD) in patients with a single previous coronary or cerebrovascular event in the Arabian Gulf.

Methods:

This was a cross-sectional, multicenter, observational survey in consecutive patients (≥18 years) with documented previous coronary and/or cerebrovascular atherothrombotic event in the United Arab Emirates (UAE), Kuwait and Qatar (64 centers), from October 2008 to December 2010. PAD was defined as an ankle brachial index <0.9 in at least one leg.

Results:

The overall mean age of the cohort (n = 2110) was 54 ± 11 years with only 14% being female (n = 303). The prevalence of asymptomatic PAD was 13.7%, with the highest prevalence seen in Kuwait (16.3%) and the UAE (14.7%) and the lowest in Qatar (5.3%). There were significant differences in the prevalence of asymptomatic PAD among the ethnic groups (p < 0.001): it was highest among the local Arabs and Caucasians at 19% and lowest among South East Asians (6%). The multivariate logistic model demonstrated that the most significant predictors of PAD were old age (adjusted odds ratio [OR], 1.04; 95% CI: 1.02–1.05; p < 0.001), female gender (OR, 1.56; 95% CI: 1.06–2.29; p = 0.024), ethnicity (OR, 0.39; 95% CI: 0.19–0.79; p = 0.009), smoking (OR, 1.70; 95% CI: 1.22–2.37: p = 0.002) and diabetes mellitus (OR, 1.49; 95% CI: 1.14–1.94; p = 0.004).

Conclusions:

PAD is prevalent in the Arabian Gulf and is more likely to be associated with old age, females, ethnicity, smokers and those with diabetes mellitus.

Keywords::

• Ankle brachial index
• Arab
• Atherosclerosis
• Kuwait
• Middle East
• Peripheral artery disease
• Predictors
• Prevalence
• Qatar
• United Arab Emirates

Transparency

Declaration of funding

The ABC in PVD project was sponsored by Sanofi-Aventis – Gulf. The sponsor had no involvement in the study conception or design; analysis, or interpretation of data; writing, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Declaration of financial/other relationships

I.A.-Z. has disclosed that he received an honorarium for his statistical analysis work-up on the ABC in PVD Disease registry. M.I. is a Medical Director of Sanofi. A.K., M.A.-B., H.A.-T., A.E.-M., J.A.S., and D.D., have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewer 1 has no relevant financial relationships to disclose. Peer reviewer 2 is CMRO’s Editor-in-Chief, but has no other relevant financial relationships to disclose.

Acknowledgments

We thank the patients, physicians, nurses, and support staff who participated in the ABC in PVD registry for their invaluable cooperation. The study has also been accepted for presentation as an abstract at the 82nd European Atherosclerosis Society Congress in Madrid, Spain in May/June 2014. The abstract is entitled ‘Asymptomatic peripheral artery disease in patients with a previous single coronary or cerebrovascular event: a multicenter cross-sectional study from the Middle East’. Abstract number EAS-1102.