Impact of cardiovascular (CV) risk factor control for short-term mortality in patients with atherosclerotic peripheral arterial disease (PAD) is not known.

We aimed to determine the prognostic value of major CV risk factor control for 1-year mortality in patients hospitalized for PAD.

Data from the COhorte des Patients ARTériopathes registry, a prospective multicenter, observational study of patients hospitalized for symptomatic PAD in academic hospitals of southwestern France, were analyzed. Associations between hypertension, diabetes, dyslipidemia and smoking status with 1-year mortality and CV events were evaluated by Cox analysis. Control of each CV risk factor was evaluated at 2 months after hospital discharge: blood pressure target<140/90mmHg, low-density lipoprotein<1g/L, glycohemoglobin<7.5% and smoking cessation. Multivariate regression analyses were performed to determine the impact of risk-factor control on 1-year CV events (CV death, myocardial infarction, stroke, amputation) and total mortality.

From July 2007 to December 2013, 670 patients with completed data 2 months after discharge were included. Most of them (66%) presented with critical limb ischemia. Hypertension (74%) was the most prevalent risk factor. The rates of one-year CV events and total mortality were 18% and 9.7%, respectively. There was no correlation between any risk factor control and improved outcomes. Rutherford grade>4 (P<0.001), heart failure (P=0.01) and diabetes (P=0.028) were correlated with CV events. Age>65years (P<0.001), Rutherford grade>4 (P=0.02), heart failure (P<0.001) and hypertension control (P=0.022) were correlated with mortality (Table 1).

One-year mortality is high in patients hospitalized for PAD. Control of major CV risk factors does not improve 1-year survival. Hypertension control was associated with poorer survival. The strictness of the target for each risk factor should be individualized in this high-risk population.