Back to Search
Start Over
Absence of Peripheral Pulses and Risk of Major Vascular Outcomes in Patients With Type 2 Diabetes.
- Source :
-
Diabetes Care . Dec2016, Vol. 39 Issue 12, p2270-2277. 8p. - Publication Year :
- 2016
-
Abstract
- <bold>Objective: </bold>The burden of vascular diseases remains substantial in patients with type 2 diabetes, requiring identification of further risk markers. We tested the absence of dorsalis pedis and posterior tibial pulses as predictors of major macrovascular and microvascular events, death, and cognitive decline in this population.<bold>Research Design and Methods: </bold>Data were derived from 11,120 patients with type 2 diabetes in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation (ADVANCE) study. Absent peripheral pulses at baseline were defined as absence of at least one dorsalis pedis or posterior tibial pulse.<bold>Results: </bold>Absent compared with present peripheral pulses (n = 2,218) were associated with increased 5-year risks for major macrovascular events (hazard ratio 1.47 [95% CI 1.28-1.69], P < 0.0001), myocardial infarction (1.45 [1.13-1.87], P = 0.003), stroke (1.57 [1.23-2.00], P = 0.0003), cardiovascular death (1.61 [1.33-1.95], P < 0.0001), heart failure (1.49 [1.21-1.84], P = 0.0002), all-cause mortality (1.48 [1.29-1.71], P < 0.0001), major microvascular events (1.17 [1.00-1.36], P = 0.04), nephropathy (1.24 [1.00-1.54], P = 0.04), end-stage renal disease or renal death (2.04 [1.12-3.70], P = 0.02), and peripheral neuropathy (1.13 [1.05-1.21], P = 0.0008) after multiple adjustment. Participants with absent dorsalis pedis or posterior tibial pulses had comparable hazard ratios. Risks increased proportionally with the number of absent peripheral pulses, with the highest risks observed in patients with three or four absent pulses. Every additional absent pulse increases the risk of all outcomes.<bold>Conclusions: </bold>Absent dorsalis pedis and/or posterior tibial pulses are independent predictors of major vascular outcomes in patients with type 2 diabetes. These simple clinical indicators should be used to improve risk stratification and treatment of these patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TYPE 2 diabetes diagnosis
*TYPE 2 diabetes complications
*STROKE diagnosis
*ACE inhibitors
*CARDIOVASCULAR disease diagnosis
*COMBINATION drug therapy
*CHRONIC kidney failure
*COMPARATIVE studies
*DIABETIC angiopathies
*GLICLAZIDE
*HYPOGLYCEMIC agents
*RESEARCH methodology
*MEDICAL cooperation
*MYOCARDIAL infarction
*TYPE 2 diabetes
*PULSE (Heart beat)
*RESEARCH
*STROKE
*EVALUATION research
*DISEASE progression
*INDAPAMIDE
*DISEASE complications
*DIAGNOSIS
CHRONIC kidney failure complications
Subjects
Details
- Language :
- English
- ISSN :
- 01495992
- Volume :
- 39
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Diabetes Care
- Publication Type :
- Academic Journal
- Accession number :
- 119722186
- Full Text :
- https://doi.org/10.2337/dc16-1594