Long‐Term Outcomes of Peripheral Artery Disease in Veterans: Analysis of the Peripheral Artery Disease Long‐Term Survival Study (PEARLS)
Background Contemporary research in peripheral artery disease (PAD) remains limited due to lack of a national registry and low accuracy of diagnosis codes to identify patients with PAD. Methods Leveraging a novel natural language processing system that identifies PAD with high accuracy using ankle‐b...
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| Language: | English |
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Wiley
2025-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.038403 |
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| author | Saket Girotra Qiang Li Mary Vaughan‐Sarrazin Brian C. Lund Mohammad Al‐Garadi Joshua A. Beckman Rohit Nathani Richard M. Hoffman Paul S. Chan Subhash Banerjee Shirling Tsai Dharam J. Kumbhani Nicole Minniefield‐Young Kim G. Smolderen Shipra Arya Cathy Nguyen Michael E. Matheny Glenn T. Gobbel |
| author_facet | Saket Girotra Qiang Li Mary Vaughan‐Sarrazin Brian C. Lund Mohammad Al‐Garadi Joshua A. Beckman Rohit Nathani Richard M. Hoffman Paul S. Chan Subhash Banerjee Shirling Tsai Dharam J. Kumbhani Nicole Minniefield‐Young Kim G. Smolderen Shipra Arya Cathy Nguyen Michael E. Matheny Glenn T. Gobbel |
| author_sort | Saket Girotra |
| collection | DOAJ |
| description | Background Contemporary research in peripheral artery disease (PAD) remains limited due to lack of a national registry and low accuracy of diagnosis codes to identify patients with PAD. Methods Leveraging a novel natural language processing system that identifies PAD with high accuracy using ankle‐brachial index and toe‐brachial index values, we created a registry of 103 748 patients with new‐onset PAD in the Veterans Health Administration. Study end points include mortality, cardiovascular events (hospitalization for acute myocardial infarction or stroke) and limb events (hospitalization for critical limb ischemia or major amputation) and were identified using Veterans Affairs and non–Veterans Affairs encounters. Results The mean age was 70.6 years; 97.3% were male, and 18.5% self‐identified as Black. The mean ankle‐brachial index value was 0.78 (SD: 0.26) and the mean toe‐brachial index value was 0.51 (SD: 0.19). A majority of patients were current (27.1%) or former (30.0%) smokers. Prevalence of hypertension (86.6%), heart failure (22.7%), diabetes (54.8%), chronic kidney disease (23.6%), and chronic obstructive pulmonary disease (35.4%) was high. At 1 year, 9.4% of patients had died. The 1‐year incidence of cardiovascular events was 5.6 per 100 patient‐years and limb events was 7.0 per 100 patient‐years. Conclusions We have successfully launched a registry of >100 000 patients with a new diagnosis of PAD in the Veterans Health Administration, the largest integrated health system in the United States. The incidence of death and clinical events in our cohort is high. Ongoing studies will yield important insights regarding improving care and outcomes in this high‐risk group. |
| format | Article |
| id | doaj-art-adba10bbd7ab47d387cae0f5a145e5a1 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-adba10bbd7ab47d387cae0f5a145e5a12025-08-20T03:07:46ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-04-0114710.1161/JAHA.124.038403Long‐Term Outcomes of Peripheral Artery Disease in Veterans: Analysis of the Peripheral Artery Disease Long‐Term Survival Study (PEARLS)Saket Girotra0Qiang Li1Mary Vaughan‐Sarrazin2Brian C. Lund3Mohammad Al‐Garadi4Joshua A. Beckman5Rohit Nathani6Richard M. Hoffman7Paul S. Chan8Subhash Banerjee9Shirling Tsai10Dharam J. Kumbhani11Nicole Minniefield‐Young12Kim G. Smolderen13Shipra Arya14Cathy Nguyen15Michael E. Matheny16Glenn T. Gobbel17University of Texas Southwestern Medical Center Dallas TXUniversity of Texas Southwestern Medical Center Dallas TXUniversity of Iowa Carver College of Medicine Iowa City IAUniversity of Iowa Carver College of Medicine Iowa City IAVanderbilt University Medical Center Kansas City MOUniversity of Texas Southwestern Medical Center Dallas TXUniversity of Texas Southwestern Medical Center Dallas TXUniversity of Iowa Carver College of Medicine Iowa City IAUniversity of Missouri‐Kansas City Kansas City MOBaylor Scott & White Hospital Dallas TXUniversity of Texas Southwestern Medical Center Dallas TXUniversity of Texas Southwestern Medical Center Dallas TXUniversity of Texas Southwestern Medical Center Dallas TXYale School of Medicine Palo Alto CAStanford School of Medicine Palo Alto CAUniversity of Texas Southwestern Medical Center Dallas TXVanderbilt University Medical Center Kansas City MOVanderbilt University Medical Center Kansas City MOBackground Contemporary research in peripheral artery disease (PAD) remains limited due to lack of a national registry and low accuracy of diagnosis codes to identify patients with PAD. Methods Leveraging a novel natural language processing system that identifies PAD with high accuracy using ankle‐brachial index and toe‐brachial index values, we created a registry of 103 748 patients with new‐onset PAD in the Veterans Health Administration. Study end points include mortality, cardiovascular events (hospitalization for acute myocardial infarction or stroke) and limb events (hospitalization for critical limb ischemia or major amputation) and were identified using Veterans Affairs and non–Veterans Affairs encounters. Results The mean age was 70.6 years; 97.3% were male, and 18.5% self‐identified as Black. The mean ankle‐brachial index value was 0.78 (SD: 0.26) and the mean toe‐brachial index value was 0.51 (SD: 0.19). A majority of patients were current (27.1%) or former (30.0%) smokers. Prevalence of hypertension (86.6%), heart failure (22.7%), diabetes (54.8%), chronic kidney disease (23.6%), and chronic obstructive pulmonary disease (35.4%) was high. At 1 year, 9.4% of patients had died. The 1‐year incidence of cardiovascular events was 5.6 per 100 patient‐years and limb events was 7.0 per 100 patient‐years. Conclusions We have successfully launched a registry of >100 000 patients with a new diagnosis of PAD in the Veterans Health Administration, the largest integrated health system in the United States. The incidence of death and clinical events in our cohort is high. Ongoing studies will yield important insights regarding improving care and outcomes in this high‐risk group.https://www.ahajournals.org/doi/10.1161/JAHA.124.038403natural language processingperipheral artery diseasesurvivalveterans |
| spellingShingle | Saket Girotra Qiang Li Mary Vaughan‐Sarrazin Brian C. Lund Mohammad Al‐Garadi Joshua A. Beckman Rohit Nathani Richard M. Hoffman Paul S. Chan Subhash Banerjee Shirling Tsai Dharam J. Kumbhani Nicole Minniefield‐Young Kim G. Smolderen Shipra Arya Cathy Nguyen Michael E. Matheny Glenn T. Gobbel Long‐Term Outcomes of Peripheral Artery Disease in Veterans: Analysis of the Peripheral Artery Disease Long‐Term Survival Study (PEARLS) Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease natural language processing peripheral artery disease survival veterans |
| title | Long‐Term Outcomes of Peripheral Artery Disease in Veterans: Analysis of the Peripheral Artery Disease Long‐Term Survival Study (PEARLS) |
| title_full | Long‐Term Outcomes of Peripheral Artery Disease in Veterans: Analysis of the Peripheral Artery Disease Long‐Term Survival Study (PEARLS) |
| title_fullStr | Long‐Term Outcomes of Peripheral Artery Disease in Veterans: Analysis of the Peripheral Artery Disease Long‐Term Survival Study (PEARLS) |
| title_full_unstemmed | Long‐Term Outcomes of Peripheral Artery Disease in Veterans: Analysis of the Peripheral Artery Disease Long‐Term Survival Study (PEARLS) |
| title_short | Long‐Term Outcomes of Peripheral Artery Disease in Veterans: Analysis of the Peripheral Artery Disease Long‐Term Survival Study (PEARLS) |
| title_sort | long term outcomes of peripheral artery disease in veterans analysis of the peripheral artery disease long term survival study pearls |
| topic | natural language processing peripheral artery disease survival veterans |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.038403 |
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