Introduction: Upper extremity arterial disease, although it occurs less frequently compared to lower extremity arterial disease, negatively impacts one’s lifestyle. Most studies on peripheral arterial disease have been focused on the lower extremities and the clinical impact of upper extremity arterial disease remains less well known.
Hypothesis: Patients with upper extremity arterial disease have similar major adverse cardiovascular events (MACE) as those with lower extremity arterial disease.
Methods: Sixty-seven consecutive patients with upper extremity arterial studies and 359 consecutive patients with lower extremity arterial studies performed in 2004 by an accredited vascular laboratory were followed for at least 2 years. MACE including death, stroke, transient ischemic attack (TIA), myocardial infarction (MI) and unstable angina (USA) were tabulated and compared between the 2 groups. Final results were adjusted for diabetes mellitus, hypertension, hyperlipidemia, smoking status, and renal insufficiency. One-tailed t test was used.
Results: Eight events (28%) occurred in 29 patients with abnormal upper extremity arterial study compared to 24 events (21%) in 112 patients with abnormal lower extremity arterial study, p=NS. Five events (13%) occurred in 38 patients with normal upper extremity arterial study compared to 8 events (28%) in those with abnormal upper extremity arterial study, p=0.02. Twenty events (8%) occurred in 247 patients with normal lower extremity arterial study compared to 24 events (21%) in those with abnormal lower extremity arterial study, p<0.0001.
Conclusion: Patients with upper extremity arterial disease defined by abnormal upper extremity arterial study have similar MACE to those with lower extremity arterial disease (28% versus 21%, p=NS). In addition, those with either upper or lower extremity arterial disease have statistically more MACE than those without disease.
Major Adverse Clinical Events
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