New research from Intermountain Health in Salt Lake City indicates that patients diagnosed with peripheral arterial disease (PAD) who also have atrial fibrillation (AFib) are at a significantly greater risk for major adverse cardiovascular events (MACE). The study, which analyzed long-term data from Intermountain Health patients, discovered that approximately one in four individuals with PAD also have AFib, highlighting a concerning prevalence that was previously underestimated.
The findings show that the presence of AFib nearly doubles the risk of experiencing major adverse cardiovascular events compared to patients with PAD alone. AFib is a common type of arrhythmia characterized by irregular heart rhythms, which can lead to symptoms such as palpitations, fatigue, and shortness of breath. This condition occurs when the heart’s upper chambers, known as atria, beat out of sync with the lower chambers, called ventricles. If left untreated, AFib can result in blood clots and significantly increase the risk of stroke and heart failure.
The study points out that PAD affects nearly 8–12 million adults in the United States. Patients with PAD often experience insufficient blood flow to their limbs, particularly the legs, leading to symptoms like claudication, which causes pain during walking. While treatments for both coronary artery disease (CAD) and PAD may be similar—including lifestyle changes such as exercise and a healthy diet—individuals with PAD face a higher likelihood of heart attacks, strokes, and amputations.
Researchers emphasized that the combination of PAD and AFib amplifies the risks associated with these conditions. “This is a stark reminder that PAD is not just a limb-threatening disease—it’s a marker of widespread atherosclerosis,” said Viet Le, DMSc, MPAS, PA-C, an advanced practice clinician and cardiovascular researcher at Intermountain Health, who served as the principal investigator of the study. “When atrial fibrillation is added to the mix, the risk of heart attack, stroke, and death escalates significantly. Clinicians must screen for AFib in PAD patients and aggressively manage both conditions.”
Implications for Medical Practice
Key findings from the study underscore the urgent need for improved adherence to screening and treatment protocols. Despite existing guidelines, only 35% of PAD patients receive optimal medical therapy, which includes control of blood pressure, use of statins, aspirin therapy, and support for smoking cessation.
“Atrial fibrillation should be assessed in all peripheral arterial disease patients, and aggressive preventative treatment should be implemented,” Le added. This call to action highlights the necessity for healthcare providers to take a comprehensive approach when treating patients with PAD, ensuring that they are fully evaluated for AFib and other related conditions.
As the research sheds light on the intersection between PAD and AFib, it not only informs clinical practices but also emphasizes the importance of patient education regarding the risks associated with these conditions. Patients diagnosed with PAD should be aware of their heightened risk for cardiovascular events and engage in proactive discussions with their healthcare providers about screening and management strategies.
With the potential for improved outcomes through better screening and treatment, this study marks a significant step forward in understanding and addressing the complexities of cardiovascular health among patients with PAD and AFib.
