Multicenter cross-sectional study of asymptomatic peripheral arterial disease among patients with a single previous coronary or cerebrovascular event in the Arabian Gulf

Objective: To evaluate the epidemiology and predictors of asymptomatic peripheral artery disease (PAD) in patients with a single previous coronary or cerebrovascular event in the Arabian Gulf. Methods: This was a cross-sectional, multicenter, observational survey in consecutive patients (≥18 years) with documented previous coronary and/or cerebrovascular atherothrombotic event in the United Arab Emirates (UAE), Kuwait and Qatar (64 centers), from October 2008 to December 2010. PAD was defined as an ankle brachial index <0.9 in at least one leg. Results: The overall mean age of the cohort (n=2110) was 54±11 years with only 14% being female (n=303). The prevalence of asymptomatic PAD was 13.7%, with the highest prevalence seen in Kuwait (16.3%) and the UAE (14.7%) and the lowest in Qatar (5.3%). There were significant differences in the prevalence of asymptomatic PAD among the ethnic groups (p<0.001): it was highest among the local Arabs and Caucasians at 19% and lowest among South East Asians (6%). The multivariate logistic model demonstrated that the most significant predictors of PAD were old age (adjusted odds ratio [OR], 1.04; 95% CI: 1.02-1.05; p<0.001), female gender (OR, 1.56; 95% CI: 1.06-2.29; p=0.024), ethnicity (OR, 0.39; 95% CI: 0.19-0.79; p=0.009), smoking (OR, 1.70; 95% CI: 1.22-2.37: p=0.002) and diabetes mellitus (OR, 1.49; 95% CI: 1.14-1.94; p=0.004). Conclusions: PAD is prevalent in the Arabian Gulf and is more likely to be associated with old age, females, ethnicity, smokers and those with diabetes mellitus.