Risk factors for concomitant peripheral arterial occlusive disease in patients with coronary artery disease: Is there a difference between diabetic and non-diabetic patients?

Aim of the study: The aim of the present study was investigation of cardiovascular risk factors for concomitant Peripheral Arterial Occlusive Disease (PAOD) in diabetic vs. non-diabetic patients with coronary artery disease (CAD). Patients and methods: This study included 302 patients (229 men) with a mean age of 62.2 +/- 11.5 years and angiographically documented CAD. These were divided into Group A comprising 116 diabetic patients (79 men) and Group B comprising 186 non-diabetic patients (150 men). Peripheral Arterial Occlusive Disease (PAOD) was diagnosed using a Doppler apparatus. Cardiovascular risk factors that were investigated included age, history of myocardial infarction, smoking, Body-Mass Index, Waist-Hip-Ratio, hypertension and serum lipids. Results: PAOD was diagnosed in 49 patients of Group A (42.4%) and 20 patients of Group B (10.8%). In Group A concomitant PAOD was associated with significantly (p=0.0001) longer diabetes duration and significantly (p=0.0001) higher frequency of insulin treatment, as well as significantly (p=0.02) higher triglycerides and significantly (p=0.039) lower HDL-Cholesterol. In Group B patients with PAOD had significantly (p=0.0001) higher age and significantly higher (p=0.041) LDL-Cholesterol levels than those without PAOD. No association was found between PAOD and presence of remaining risk factors in either group. In multiple regression analysis, concomitant PAOD was associated with diabetes duration (p=0.0026) and insulin treatment (p=0.0004) in Group A, while it was associated with age (p=0.01) in Group B. The associations with serum lipids were no longer significant. Conclusions: Among non-diabetic patients with CAD, those who have concomitant PAOD are significantly older. Among diabetic patients with CAD, those who have concomitant PAOD show significantly longer diabetes duration and significantly higher frequency of insulin treatment.