Effects of Three Different Methods Defining Onset of Peripheral Artery Disease on the Assessments of Incidence and Important Predictors – Results from the German Epidemiological Trial on Ankle Brachial Index (getABI)

Figures & data

Table 1 Baseline Characteristics of PAD-free Group in Comparison to the Cohort

		All Patients N(%)	PAD-free Patients at Baseline N(%)
Total		6,822 (100)	5,269 (100)
Age >75 years		2,091 (30.7)	1,445 (27.4)
Sex	Male	2,863 (42.0)	2,145 (40.7)
	Female	3,959 (58.0)	3,124 (59.3)
Active smoking status		634 (9.3)	409 (7.8)
Arterial hypertension		4,735 (69.4)	3,446 (65.4)
Diabetes		1,744 (25.6)	1,188 (22.6)
Lipid metabolism	LDL ≥130 mg/dL	2,921 (42.8)	2,290 (43.5)
	Lipid lowering medication	1,607 (23.6)	1,146 (21.8)
BMI ≥30 kg/m^2		1,575 (23.1)	1,188 (22.6)
Pre-existing cardio- or cerebrovascular disease		1,091 (16.0)	681 (12.9)
Low ISCED (0–2)		1,698 (24.9)	1,272 (24.1)
HCY > median		3,419 (50.1)	2,514 (47.7)
CRP >3 mg/L		2,642 (38.7)	1,918 (36.4)
GGT highest quartile		1,676 (24.6)	1,243 (23.6)
eGFR <60 mL/min/1.73 m^2		1,337 (19.6)	891 (16.9)
Vitamin D <50 nmol/L		4,741 (69.5)	3,574 (67.8)

Abbreviations: PAD, peripheral artery disease; LDL, Low density lipoprotein; BMI, body mass index; ISCED, International Standard Classification of Education; HCY, homocysteine; CRP, C-reactive protein; GGT, gamma-glutamyl transferase; eGFR, estimated glomerular filtration rate.

Table 2 Number of Events, Person Years, and Event Rates

PAD Definition	Number of Events	Median Time Until PAD Onset (Years)	Time Under Risk (Sum of Person Years)	Events per 1,000 Person Years (95% CI)
Single ABI method	1,270	3.0	30,810	41.2 (38.95–43.49)
Regression method A	810	2.9	32,349	25.0 (23.32–26.77)
Regression method B	1,077	3.4	31,732	33.9 (31.91–35.97)

Abbreviations: PAD, peripheral artery disease; CI, confidence interval.

Table 3 Association Between Risk Factors at Baseline and PAD Incidence, Univariable Analysis

Risk factors		HR (95% CI); p value
		1st PAD definition (Single ABI)		2nd PAD definition (Regression A)		3rd PAD definition (Regression B)
Age >75 years		1.34 (1.19-1.51)	<0,001	1.68 (1.45-1.94)	<0.001	1.81 (1.60-2.05)	<0.001
Male sex		1.05 (0.96-1.15)	0.283	1.28 (1.15-1.42)	<0.001	1.16 (1.05-1.28)	0.003
Active smoking status		1.72 (1.49-1.98)	<0,001	1.92 (1.65-2.25)	<0.001	1.80 (1.55-2.09)	<0.001
Arterial hypertension		1.52 (1.38-1.68)	<0.001	1.54 (1.37-1.73)	<0.001	1.47 (1.32-1.63)	<0.001
Diabetes		1.42 (1.28-1.57)	<0.001	1.54 (1.38-1.72)	<0.001	1.52 (1.36-1.69)	<0.001
Lipid metabolism	LDL ≥130 mg/dL	0.99 (0.91-1.09)	0.883	0.92 (0.83-1.02)	0.112	0.95 (0.86-1.05)	0.313
	Lipid lowering medication	1.03 (0.93-1.15)	0.576	0.96 (0.85-1.09)	0.506	0.92 (0.82-1.04)	0.171
BMI ≥30 kg/m²		1.20 (1.08-1.33)	<0.001	1.14 (1.01-1.28)	0.030	1.17 (1.05-1.31)	0.005
Pre-existing cardiovascular or cerebrovascular disease		1.60 (1.42-1.80)	<0.001	1.85 (1.63-2.11)	<0.001	1.70 (1.50-1.93)	<0.001
Low ISCED (0-2)		1.31 (1.18-1.44)	<0.001	1.27 (1.14-1.43)	<0.001	1.32 (1.19-1.47)	<0.001
HCY > median		1.38 (1.26-1.52)	<0.001	1.47 (1.32-1.62)	<0.001	1.38 (1.25-1.52)	<0.001
CRP >3 mg/L		1.30 (1.19-1.43)	<0.001	1.38 (1.25-1.53)	<0.001	1.37 (1.24-1.51)	<0.001
GGT highest quartile		1.22 (1.10-1.35)	<0.001	1.30 (1.16-1.45)	<0.001	1.25 (1.12-1.39)	<0.001
eGFR <60 mL/min/1.73 m²		1.61 (1.45-1.79)	<0.001	1.85 (1.64-2.08)	<0.001	1.82 (1.63-2.04)	<0.001
Vitamin D <50 nmol/L		1.39 (1.26-1.54)	<0.001	1.40 (1.25-1.58)	<0.001	1.44 (1.29-1.61)	<0.001

Abbreviations: PAD, peripheral artery disease; LDL, Low density lipoprotein; BMI, body mass index; ISCED, International Standard Classification of Education; HCY, homocysteine; CRP, C-reactive protein; GGT, gamma-glutamyl transferase; eGFR, estimated glomerular filtration rate; CI, confidence interval; N, number.

Table 4 Association Between Risk Factors at Baseline and PAD Incidence, Multivariable Analysis

Risk factors		HR (95% CI); p value
		1st PAD definition (Single ABI)		2nd PAD definition (Regression A)		3rd PAD definition (Regression B)
Age >75 years		1.28 (1.12-1.46)	<0.001	1.66 (1.42-1.95)	<0.001	1.72 (1.50-1.97)	<0.001
Male sex		0.89 (0.78-1.01)	0.068	1.10 (0.94-1.29)	0.235	1.06 (0.92-1.21)	0.450
Active smoking status		1.79 (1.50-2.15)	<0.001	2.36 (1.92-2.90)	<0.001	2.08 (1.72-2.51)	<0.001
Arterial Hypertension		1.37 (1.21-1.56)	<0.001	1.38 (1.17-1.63)	<0.001	1.23 (1.07-1.41)	0.004
Diabetes		1.20 (1.06-1.37)	0.006	1.33 (1.13-1.56)	<0.001	1.33 (1.16-1.53)	<0.001
Lipid metabolism	LDL ≥130 mg/dL	1.23 (1.10-1.38)	<0.001	1.25 (1.08-1.44)	0.002	1.15 (1.02-1.30)	0.025
	Lipid lowering medication	1.12 (0.98-1.28)	0.089	1.04 (0.88-1.23)	0.646	0.95 (0.82-1.11)	0.526
BMI ≥30 kg/m²		1.17 (1.03-1.34)	0.020	1.19 (1.01-1.40)	0.041	1.19 (1.03-1.37)	0.020
Pre-existing cardiovascular or cerebrovascular disease		1.45 (1.24-1.70)	<0.001	1.79 (1.48-2.15)	<0.001	1.64 (1.39-1.93)	<0.001
Low ISCED (0-2)		1.27 (1.12-1.45)	<0.001	1.36 (1.15-1.60)	<0.001	1.36 (1.18-1.56)	<0.001
HCY > median		1.18 (1.05-1.32)	0.005	1.15 (1.00-1.33)	0.057	1.10 (0.97-1.24)	0.141
CRP >3 mg/L		1.12 (1.00-1.26)	0.052	1.19 (1.03-1.38)	0.018	1.22 (1.08-1.38)	0.002
GGT highest quartile		1.05 (0.92-1.19)	0.492	1.13 (0.96-1.32)	0.145	1.08 (0.94-1.25)	0.266
eGFR <60 mL/min/1.73 m²		1.04 (0.89-1.22)	0.624	1.06 (0.88-1.28)	0.554	1.18 (1.00-1.38)	0.051
Vitamin D <50 nmol/L		1.10 (0.97-1.26)	0.133	1.07 (0.91-1.26)	0.390	1.16 (1.01-1.33)	0.042

Abbreviations: PAD, peripheral artery disease; LDL, Low density lipoprotein; BMI, body mass index; ISCED, International Standard Classification of Education; HCY, homocysteine; CRP, C-reactive protein; GGT, gamma-glutamyl transferase; eGFR, estimated glomerular filtration rate; CI, confidence interval; N, number.