Abstract
Objectives: Since our previous study showed the 3 years mortality rate in diabetic patients with peripheral arterial disease (PAD) is very high (56.5%). The investigator therefore would like to evaluate the risk factors to determine the high cardiovascular morbidity and mortality in 3 years cohort study. In this first year report, we illustrated the screening PAD in diabetic patients and then showed the cardiovascular morbidity and mortality rate in 6 month period. Also the risk factors for atherosclerosis was scrutinized.
Method: Between May 2014 and August 2014, consecutive eligible outpatients, aged ≥45 years with established DM in 3 hospitals in Northern Thailand, were invited to be involved in this study. History, physical exam and laboratory test were reviewed. Ankle brachial index ≤ 0.9 was considered PAD. Then patients were evaluated the percentage of risk factor control according to American Heart Association (AHA) criteria. ]
Result: 2,247 diabetic patients were recruited for the study. 286 patients out of 2,247 were diagnosed PAD(12.7%). 236 PAD patients(82.5%) did not have any symptom of PAD namely intermittent claudication, rest pain, gangrene or ulcer. According to AHA criteria, the percentage of adequate control in low density lipoprotein, HbA1C and systolic blood pressure in PAD patients was 18.9, 30.1 and 33.2% respectively. In the 6 months follow up study, there were 11 death, 7 non- fatal myocardial infarction and 3 non-fatal stroke. Comparing with the first visit, the systolic blood pressure and waist circumference was worsening.
Conclusion: The prevalence of PAD in diabetic patients was 12.7%. Most PAD in diabetic patients was asymptomatic. Therefore the ABI screening in all diabetic patients must be performed to early detection and proper management. The atherosclerotic risk factor control was poorly controlled in this group. The number of cardiovascular event was too small to analyse the risk factors to determine cardiovascular morbidity and mortality. More further data are needed.
