{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:41:52Z","timestamp":1785307312211,"version":"3.55.0"},"reference-count":31,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T00:00:00Z","timestamp":1608076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI07\/0403, PI15\/00510)"],"award-info":[{"award-number":["PI07\/0403, PI15\/00510)"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Cardiovascular events are a major cause of mortality and morbidity worldwide. The risk of recurrence after a first cardiovascular event has been documented in the international literature, although not as extensively in a Mediterranean population-based cohort with low cardiovascular risk. There is also ample, albeit contradictory, research on the recurrence of stroke and myocardial infarctions (MI) after a first event and the factors associated with such recurrence, including the role of pathological Ankle-Brachial Index (ABI). Methods: The Peripheral Arterial ARTPER study is aimed at deepening our knowledge of patient evolution after a first cardiovascular event in a Mediterranean population with low cardiovascular risk treated at a primary care centre. We study overall recurrence, cardiac and cerebral recurrence. We studied participants in the ARTPER prospective observational cohort, excluding patients without cardiovascular events or with unconfirmed events and patients who presented arterial calcification at baseline or who died. In total, we analyzed 520 people with at least one cardiovascular event, focusing on the presence and type of recurrence, the risk factors associated with recurrence and the behavior of the ankle-brachial index (ABI) as a predictor of risk. Results: Between 2006 and 2017, 46% of patients with a first cardiovascular event experienced a recurrence of some type; most recurrences fell within the same category as the first event. The risk of recurrence after an MI was greater than after a stroke. In our study, recurrence increased with age, the presence of peripheral arterial disease (PAD), diabetes and the use of antiplatelets. Diabetes mellitus was associated with all types of recurrence. Additionally, patients with an ABI &lt; 0.9 presented more recurrences than those with an ABI \u2265 0.9. Conclusions: In short, following a cardiac event, recurrence usually takes the form of another cardiac event. However, after having a stroke, the chance of having another stroke or having a cardiac event is similar. Lastly, ABI &lt; 0.9 may be considered a predictor of recurrence risk.<\/jats:p>","DOI":"10.3390\/jcm9124064","type":"journal-article","created":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T22:12:06Z","timestamp":1608156726000},"page":"4064","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Long-Term Morbidity and Mortality after First and Recurrent Cardiovascular Events in the ARTPER Cohort"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7485-7136","authenticated-orcid":false,"given":"Marina","family":"Escofet Peris","sequence":"first","affiliation":[{"name":"Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d\u2019Investigaci\u00f3 en Atenci\u00f3 Prim\u00e0ria Jordi Gol (IDIAP Jordi Gol), 08303 Matar\u00f3, Spain"},{"name":"Masnou Primary Healthcare Centre, Ger\u00e8ncia d\u2019\u00c0mbit d\u2019Atenci\u00f3 Prim\u00e0ria Metropolitana Nord, Institut Catal\u00e0 de la Salut, 08320 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Alzamora","sequence":"additional","affiliation":[{"name":"Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d\u2019Investigaci\u00f3 en Atenci\u00f3 Prim\u00e0ria Jordi Gol (IDIAP Jordi Gol), 08303 Matar\u00f3, Spain"},{"name":"Riu Nord-Riu Sud Primary Healthcare Centre, Santa Coloma de Gramenet, Ger\u00e8ncia d\u2019\u00c0mbit d\u2019Atenci\u00f3 Prim\u00e0ria Metropolitana Nord, Institut Catal\u00e0 de la Salut, 08921 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9922-2380","authenticated-orcid":false,"given":"Marta","family":"Valverde","sequence":"additional","affiliation":[{"name":"Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d\u2019Investigaci\u00f3 en Atenci\u00f3 Prim\u00e0ria Jordi Gol (IDIAP Jordi Gol), 08303 Matar\u00f3, Spain"},{"name":"Department of Emergency Service, Andorran Health Care Service, Hospital Nuestra Se\u00f1ora de Meritxell, AD700 Escaldes-Engordany, Andorra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Fores","sequence":"additional","affiliation":[{"name":"Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d\u2019Investigaci\u00f3 en Atenci\u00f3 Prim\u00e0ria Jordi Gol (IDIAP Jordi Gol), 08303 Matar\u00f3, Spain"},{"name":"Riu Nord-Riu Sud Primary Healthcare Centre, Santa Coloma de Gramenet, Ger\u00e8ncia d\u2019\u00c0mbit d\u2019Atenci\u00f3 Prim\u00e0ria Metropolitana Nord, Institut Catal\u00e0 de la Salut, 08921 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3188-7268","authenticated-orcid":false,"given":"Guillem","family":"Pera","sequence":"additional","affiliation":[{"name":"Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d\u2019Investigaci\u00f3 en Atenci\u00f3 Prim\u00e0ria Jordi Gol (IDIAP Jordi Gol), 08303 Matar\u00f3, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Miguel","family":"Baena-D\u00edez","sequence":"additional","affiliation":[{"name":"La Marina Primary Healthcare Centre, Ger\u00e8ncia d\u2019\u00c0mbit d\u2019Atenci\u00f3 Prim\u00e0ria Barcelona Ciutat, Institut Catal\u00e0 de la Salut, 08038 Barcelona, Spain"},{"name":"Unitat de Suport a la Recerca de l\u2019\u00c0mbit de l\u2019Atenci\u00f3 Prim\u00e0ria de Barcelona Ciutat, Institut Universitari d\u2019Investigaci\u00f3 en Atenci\u00f3 Prim\u00e0ria Jordi Gol (IDIAP Jordi Gol), 08007 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9865-7427","authenticated-orcid":false,"given":"Pere","family":"Toran","sequence":"additional","affiliation":[{"name":"Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d\u2019Investigaci\u00f3 en Atenci\u00f3 Prim\u00e0ria Jordi Gol (IDIAP Jordi Gol), 08303 Matar\u00f3, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,16]]},"reference":[{"key":"ref_1","unstructured":"Ministerio de Sanidad (2020, December 14). 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