Prognosis of Asymptomatic Peripheral Artery Disease Incidentally Detected on Abdominal Contrast Enhanced Computed Tomography: A Retrospective Single Centre Experience.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 42288188.
- Also identified by DOI 10.1016/j.ejvs.2026.06.016.
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Abstract
Asymptomatic peripheral artery disease (aPAD) may be identified through dedicated vascular assessment (classical aPAD) or incidentally during imaging performed for non-vascular indications (hidden aPAD). Although classical aPAD has been widely studied, long term outcome data specifically addressing hidden aPAD remain limited. This study aimed to describe the prevalence and 5 year cardiovascular outcomes of hidden aPAD identified on abdominal contrast enhanced computed tomography (CT) in a single centre, retrospective cohort. This single centre, retrospective, observational study included consecutive patients aged 40 - 85 years undergoing abdominal contrast enhanced CT. Patients with previous atherosclerotic cardiovascular disease (ASCVD) and who had undergone contrast enhanced CT for ASCVD screening were excluded. Participants were stratified into hidden aPAD and non-PAD groups based on the presence or absence of atherosclerotic lesions in the iliac arteries. The primary outcome was major adverse cardiovascular event (MACE) incidence during five year follow up. The cumulative event rates were estimated using Kaplan-Meier estimation and compared using a log rank test. Cox regression analysis was performed to identify independent predictors of MACE. The study included 3 022 patients (57.9% men, mean age 69.1 ± 10.3 years, hidden aPAD n = 52, non-PAD n = 2 970). The incidence of MACE was significantly higher in patients with hidden aPAD than in the non-PAD group (23.1% vs. 2.5%, p < .001). Kaplan-Meier analysis showed markedly lower MACE free survival in the hidden aPAD group (log rank p < .001). Multivariable Cox regression analysis showed that iliac atherosclerotic lesions were independently associated with MACE (hazard ratio 8.17; 95% confidence interval 4.40 - 15.17; p < .001) even without previous ASCVD. Patients with hidden aPAD incidentally identified on abdominal contrast enhanced CT without previous ASCVD have increased cardiovascular risk.