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Comment & Response
October 2016

Risk-Reduction Program for Cardiovascular and Limb Events in Patients With Peripheral Arterial Disease

Author Affiliations
  • 1Department of Hygiene and Public Health, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
JAMA Surg. 2016;151(10):990. doi:10.1001/jamasurg.2016.2257

To the Editor Hussain et al1 investigated the efficacy of a risk-reduction program that promoted the use of medications, smoking cessation, and weight control for the prevention of cardiovascular and limb events in patients with peripheral arterial disease (PAD). The median follow-up for the cohort was 5.3 years; propensity score matching was used to match each patient with up to 2 control patients with PAD, and the data were applied to Cox proportional hazards regression analysis. The adjusted hazard ratio of interventions was significantly reduced for vascular events such as major amputation, minor amputation, bypass surgery, or hospitalization due to heart failure, and the authors recommended further study to examine the effect of risk-reduction programs on reducing PAD-related morbidity, mortality, and health care costs. There is a useful Invited Commentary,2 and I have additional queries about their study.