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Comment & Response |

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

Tomoyuki Kawada, MD, PhD1
[+] Author Affiliations
1Department of Hygiene and Public Health, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
JAMA Surg. Published online August 03, 2016. doi:10.1001/jamasurg.2016.2257
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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.


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August 3, 2016
Mohamad A. Hussain, MD; Mohammed Al-Omran, MD, MSc; Thomas F. Lindsay, MDCM, MSc
1Department of Surgery, University of Toronto, Toronto, Ontario, Canada
1Department of Surgery, University of Toronto, Toronto, Ontario, Canada2Division of Vascular Surgery, Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Ontario, Canada3King Saud University–Li Ka Shing Collaborative Research Program and Department of Surgery, King Saud University, Riyadh, Saudi Arabia
1Department of Surgery, University of Toronto, Toronto, Ontario, Canada4Division of Vascular Surgery, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
JAMA Surg. Published online August 03, 2016.;():. doi:10.1001/jamasurg.2016.2260.
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