{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:57:52Z","timestamp":1777946272623,"version":"3.51.4"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,10,27]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Although patients with peripheral artery disease (\n              <jats:styled-content style=\"fixed-case\">PAD)<\/jats:styled-content>\n              are known to have an increased risk of adverse prognosis, simple techniques to further risk\u2010stratify\n              <jats:styled-content style=\"fixed-case\">PAD<\/jats:styled-content>\n              patients would be clinically useful. A plausible but unexplored factor to predict such risk would be greater disease burden, manifested as multiple lower extremity lesions. The aim of this study was to examine the association between having multiple versus isolated lower extremity PAD lesions and long\u2010term prognosis.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A prospective cohort of 756 newly diagnosed\n              <jats:styled-content style=\"fixed-case\">PAD<\/jats:styled-content>\n              patients underwent duplex ultrasound testing to determine the number of lower extremity lesions. Cox regression models examined the independent association of lesion number (\u22653 and 2 versus 1) and adverse prognosis (defined as a composite end point comprising first occurrence of either lower extremity amputation, admission for heart failure, nonfatal stroke, myocardial infarction, or unstable angina or mortality), adjusting for demographic and clinical risk factors. Analyses were replicated using an advanced Cox\u2010based model for multiple events. A total of 173 patients (23%) had \u22653 lesions, 197 (26%) had 2 lesions, and 386 (51%) had 1 lesion. After a median follow\u2010up of 3.2\u00a0years, patients with \u22653 lesions had an increased risk of experiencing a first adverse event (adjusted hazard ratio 1.60, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.08\u20132.38,\n              <jats:italic>P<\/jats:italic>\n              =0.020) and an increased risk of having multiple events (adjusted hazard ratio 1.53, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.08\u20132.18,\n              <jats:italic>P<\/jats:italic>\n              =0.018). Patients with 2 lesions had a prognosis similar to those with 1 lesion.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Among\n              <jats:styled-content style=\"fixed-case\">PAD<\/jats:styled-content>\n              patients, a greater number of lesions is associated with an increased risk of an adverse prognosis over 3\u00a0years of follow\u2010up. Assessing the number of lower extremity lesions might serve as a simple risk\u2010stratification tool at initial\n              <jats:styled-content style=\"fixed-case\">PAD<\/jats:styled-content>\n              diagnosis.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.001823","type":"journal-article","created":{"date-parts":[[2015,10,27]],"date-time":"2015-10-27T02:08:30Z","timestamp":1445911710000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Long\u2010Term Prognostic Risk in Lower Extremity Peripheral Arterial Disease as a Function of the Number of Peripheral Arterial Lesions"],"prefix":"10.1161","volume":"4","author":[{"given":"Kim G.","family":"Smolderen","sequence":"first","affiliation":[{"name":"Department of Public Health, Faculty of Medicine &amp; Health Sciences Ghent Univeristy, Ghent, Belgium"},{"name":"University of Missouri\u2010Kansas City (UMKC), Kansas City, MO"},{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moniek","family":"van Zitteren","sequence":"additional","affiliation":[{"name":"St. Elisabeth Hospital, Department of Vascular Surgery, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip G.","family":"Jones","sequence":"additional","affiliation":[{"name":"St. Elisabeth Hospital, Department of Vascular Surgery, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"University of Missouri\u2010Kansas City (UMKC), Kansas City, MO"},{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan M.","family":"Heyligers","sequence":"additional","affiliation":[{"name":"St. Elisabeth Hospital, Department of Vascular Surgery, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria J.","family":"Nooren","sequence":"additional","affiliation":[{"name":"St. Elisabeth Hospital, Department of Vascular Surgery, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick W.","family":"Vriens","sequence":"additional","affiliation":[{"name":"St. Elisabeth Hospital, Department of Vascular Surgery, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Denollet","sequence":"additional","affiliation":[{"name":"Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology Tilburg University, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.05.030"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.09.053"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1322"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.03.067"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.11.1197"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.174526"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182031a3c"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.023"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/000331978503600508"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.01.077"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.10.115"},{"key":"e_1_3_5_13_2","unstructured":"Diagnostics and treatment of arterial disease in the lower extremities. 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