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Article ; Online: Epidemiology of thoracoabdominal aortic aneurysms.

Stoecker, Jordan B / Wang, Grace J

2021 Volume 34, Issue 1, Page(s) 18–28

Abstract: Thoracoabdominal aortic aneurysms, although rare, continue to be associated with high morbidity and mortality in the modern era of vascular surgery, and knowledge of this disease is essential for those in clinical practice. Given the clinically silent ... ...

Abstract	Thoracoabdominal aortic aneurysms, although rare, continue to be associated with high morbidity and mortality in the modern era of vascular surgery, and knowledge of this disease is essential for those in clinical practice. Given the clinically silent nature of the disease, it is difficult to determine disease incidence, with most epidemiologic recommendations not made based on evidence regarding those diagnosed with the disease, but extrapolated from data on surgical outcomes. It appears that although men are more likely to develop thoracoabdominal aortic aneurysms, the distribution is not as skewed as in abdominal aortic aneurysms. Current evidence suggests that Black and Hispanic patients continue to have disproportionately poor disease outcomes, mostly attributed to later presentation and undergoing interventions at lower-volume centers. Although select patients meet criteria for disease screening based on personal or family history of aneurysmal disease, general population screening has not been recommended by any professional organization to date. Vascular surgeons need to continue to be at the forefront of thoracoabdominal aortic aneurysm management, especially as care becomes centered around comprehensive "aortic care centers" and as more endovascular therapies become available.
MeSH term(s)	Age Factors ; Aged ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/epidemiology ; Aortic Aneurysm, Thoracic/therapy ; Female ; Health Status Disparities ; Healthcare Disparities ; Humans ; Incidence ; Male ; Middle Aged ; Prevalence ; Race Factors ; Risk Assessment ; Risk Factors ; Sex Factors ; Treatment Outcome ; United States/epidemiology
Language	English
Publishing date	2021-02-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	645131-7
ISSN	1558-4518 ; 0895-7967
ISSN (online)	1558-4518
ISSN	0895-7967
DOI	10.1053/j.semvascsurg.2021.02.001
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Article: Review of Type III Endoleaks.

Stoecker, Jordan B / Glaser, Julia D

Seminars in interventional radiology

2020 Volume 37, Issue 4, Page(s) 371–376

Abstract: Endoleak remains a significant challenge to endovascular aneurysm repair, particularly as evolving techniques and devices have allowed treatment of increasingly complex aneurysm anatomy with increasing number of device components. Intervention is ... ...

Abstract	Endoleak remains a significant challenge to endovascular aneurysm repair, particularly as evolving techniques and devices have allowed treatment of increasingly complex aneurysm anatomy with increasing number of device components. Intervention is recommended for both type I and III endoleaks due to their risk of rupture, and endovascular techniques are the favored modality with placement of a bridging endograft over the endoleak defect. Conversion to open surgical repair remains the definitive option in cases where less invasive methods have failed or are precluded. In this article, the authors review evidence on the etiology, incidence, diagnosis, and current techniques for type III endoleak management.
Language	English
Publishing date	2020-10-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	848341-3
ISSN	1098-8963 ; 0739-9529
ISSN (online)	1098-8963
ISSN	0739-9529
DOI	10.1055/s-0040-1715874
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Article: Review of Type III Endoleaks

Stoecker, Jordan B. / Glaser, Julia D.

Seminars in Interventional Radiology

(Aortic Interventions)

2020 Volume 37, Issue 04, Page(s) 371–376

Series title	Aortic Interventions
Abstract	Endoleak remains a significant challenge to endovascular aneurysm repair, particularly as evolving techniques and devices have allowed treatment of increasingly complex aneurysm anatomy with increasing number of device components. Intervention is recommended for both type I and III endoleaks due to their risk of rupture, and endovascular techniques are the favored modality with placement of a bridging endograft over the endoleak defect. Conversion to open surgical repair remains the definitive option in cases where less invasive methods have failed or are precluded. In this article, the authors review evidence on the etiology, incidence, diagnosis, and current techniques for type III endoleak management.
Keywords	endoleak ; aortic aneurysm ; surgery ; stent graft ; interventional radiology ; endovascular aneurysm repair
Language	English
Publishing date	2020-10-01
Publisher	Thieme Medical Publishers
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	848341-3
ISSN	1098-8963 ; 0739-9529
ISSN (online)	1098-8963
ISSN	0739-9529
DOI	10.1055/s-0040-1715874
Database	Thieme publisher's database

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Article ; Online: Dialysis Access-Associated Steal Syndrome and Management.

Stoecker, Jordan B / Li, Xin / Clark, Timothy W I / Mantell, Mark P / Trerotola, Scott O / Vance, Ansar Z

Cardiovascular and interventional radiology

2023 Volume 46, Issue 9, Page(s) 1168–1181

Abstract: Dialysis-associated steal syndrome (DASS) occurs in 1-8% of hemodialysis patients with arteriovenous (AV) access. Major risk factors include use of the brachial artery for access creation, female sex, diabetes, and age > 60 years. DASS carries severe ... ...

Abstract	Dialysis-associated steal syndrome (DASS) occurs in 1-8% of hemodialysis patients with arteriovenous (AV) access. Major risk factors include use of the brachial artery for access creation, female sex, diabetes, and age > 60 years. DASS carries severe patient morbidity including tissue or limb loss if not recognized and managed promptly, as well as increased mortality. Diagnosis of DASS requires a directed history and physical exam supported by non-invasive testing. Prior to definitive therapy, detailed arteriography, fistulography, and flow measurements are performed to delineate underlying etiologies and guide management. To optimize success, DASS treatment should be individualized according to access location, underlying vascular disease, flow dynamics, and provider expertise. Possible causes of DASS include extremity inflow or outflow arterial occlusive disease, high AV access flow rate, and reversal of distal extremity arterial blood flow; DASS may also exist without any of the prior features. Depending on the DASS etiology, various endovascular and/or surgical interventions should be considered. Regardless, in the majority of patients presenting with DASS, access preservation can be achieved.
MeSH term(s)	Humans ; Female ; Middle Aged ; Arteriovenous Shunt, Surgical/adverse effects ; Renal Dialysis/adverse effects ; Ischemia/diagnostic imaging ; Ischemia/etiology ; Ischemia/therapy ; Vascular Diseases ; Brachial Artery/surgery ; Treatment Outcome
Language	English
Publishing date	2023-05-24
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603082-8
ISSN	1432-086X ; 0342-7196 ; 0174-1551
ISSN (online)	1432-086X
ISSN	0342-7196 ; 0174-1551
DOI	10.1007/s00270-023-03462-6
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Article ; Online: Local aortic aneurysm wall expansion measured with automated image analysis.

Stoecker, Jordan B / Eddinger, Kevin C / Pouch, Alison M / Vrudhula, Amey / Jackson, Benjamin M

JVS-vascular science

2021 Volume 3, Page(s) 48–63

Abstract: Background: Assessment of regional aortic wall deformation (RAWD) might better predict for abdominal aortic aneurysm (AAA) rupture than the maximal aortic diameter or growth rate. Using sequential computed tomography angiograms (CTAs), we developed a ... ...

Abstract	Background: Assessment of regional aortic wall deformation (RAWD) might better predict for abdominal aortic aneurysm (AAA) rupture than the maximal aortic diameter or growth rate. Using sequential computed tomography angiograms (CTAs), we developed a streamlined, semiautomated method of computing RAWD using deformable image registration (dirRAWD). Methods: Paired sequential CTAs performed 1 to 2 years apart of 15 patients with AAAs of various shapes and sizes were selected. Using each patient's initial CTA, the luminal and aortic wall surfaces were segmented both manually and semiautomatically. Next, the same patient's follow-up CTA was aligned with the first using automated rigid image registration. Deformable image registration was then used to calculate the local aneurysm wall expansion between the sequential scans (dirRAWD). To measure technique accuracy, the deformable registration results were compared with the local displacement of anatomic landmarks (fiducial markers), such as the origin of the inferior mesenteric artery and/or aortic wall calcifications. Additionally, for each patient, the maximal RAWD was manually measured for each aneurysm and was compared with the dirRAWD at the same location. Results: The technique was successful in all patients. The mean landmark displacement error was 0.59 ± 0.93 mm with no difference between true landmark displacement and deformable registration landmark displacement by Wilcoxon rank sum test ( Conclusions: We found accurate and automated RAWD measurements were feasible with clinically insignificant errors. Using semiautomated AAA segmentations for deformable image registration methods did not alter maximal dirRAWD accuracy compared with using manual AAA segmentations. Future work will compare dirRAWD with finite element analysis-derived regional wall stress and determine whether dirRAWD might serve as an independent predictor of rupture risk.
Language	English
Publishing date	2021-12-08
Publishing country	United States
Document type	Journal Article
ISSN	2666-3503
ISSN (online)	2666-3503
DOI	10.1016/j.jvssci.2021.11.004
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Article ; Online: A large series of true pancreaticoduodenal artery aneurysms.

Stoecker, Jordan B / Eddinger, Kevin C / Glaser, Julia D / Wang, Grace J / Shlansky-Goldberg, Richard D / Fairman, Ronald M / Jackson, Benjamin M

Journal of vascular surgery

2022 Volume 75, Issue 5, Page(s) 1634–1642.e1

Abstract: Introduction: True pancreaticoduodenal artery aneurysms (PDAAs) are rare, and prior reports often fail to distinguish true aneurysms from pseudoaneuryms. We sought to characterize all patients who presented to our health system from 2004 to 2019 with ... ...

Abstract	Introduction: True pancreaticoduodenal artery aneurysms (PDAAs) are rare, and prior reports often fail to distinguish true aneurysms from pseudoaneuryms. We sought to characterize all patients who presented to our health system from 2004 to 2019 with true PDAAs, with a focus on risk factors, interventions, and patient outcomes. Methods: Patients were identified by querying a single health system picture archiving and communication system database for radiographic reports noting a PDAA. A retrospective chart review was performed on all identified patients. Patients with pseudoaneurysm, identified as those with a history of pancreatitis, abdominal malignancy, hepatopancreaticobiliary surgery, or abdominal trauma, were excluded. Continuous variables were compared using t-tests, and categorical variables were compared using Fisher's exact tests. Results: A total of 59 true PDAAs were identified. Forty aneurysms (68%) were intact (iPDAAs) and 19 (32%) were ruptured (rPDAAs) at presentation. The mean size of rPDAAs was 16.4 mm (median size, 14.0 mm; range, 10-42 mm), and the mean size of iPDAAs was 19.4 mm (median size, 17.5 mm; range, 8-88 mm); this difference was not statistically significant (P = .95). Significant celiac disease (occlusion or >70% stenosis) was noted in 39 aneurysms (66%). Those with rupture were less likely to have significant celiac disease (42% vs 78%; P = .017) and less likely to have aneurysmal wall calcifications (6% vs 53%; P = .002). Thirty-seven patients underwent intervention (63%), with eight (22%) undergoing concomitant hepatic revascularization (two stents and six bypasses) due to the presence of celiac disease. Eighteen patients with occluded celiac arteries underwent aneurysm intervention; of those, 11 were performed without hepatic revascularization (61.1%). Those with rPDAAs experienced an aneurysm-related mortality of 10.5%, whereas those with iPDAAs experienced a rate of 5.6%. One patient with celiac occlusion and PDA rupture who did not undergo hepatic artery bypass expired postoperatively from hepatic ischemia. rPDAAs showed a trend toward the increased need for aneurysm-related endovascular or open reintervention, but this was not statistically significant (47% vs 28%; P = .13). Conclusions: These findings support previous reports that the rupture risk of PDAAs is independent of size, their development is often associated with significant celiac stenosis or occlusion, and rupture risk appears decreased in patients with concomitant celiac disease or aneurysm wall calcifications. Endovascular intervention is the preferred initial treatment for both iPDAAs and rPDAAs, but reintervention rates are high in both groups. The role for hepatic revascularization remains uncertain, but it does not appear to be mandatory in all patients with complete celiac occlusion who undergo PDAA interventions.
MeSH term(s)	Aneurysm/diagnostic imaging ; Aneurysm/surgery ; Celiac Artery/diagnostic imaging ; Celiac Artery/surgery ; Celiac Disease/complications ; Constriction, Pathologic/complications ; Duodenum/blood supply ; Embolization, Therapeutic/adverse effects ; Humans ; Pancreas/blood supply ; Pancreas/diagnostic imaging ; Pancreas/surgery ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2022-01-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2022.01.021
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Article ; Online: The Differential Impact of Medicaid Expansion on Disparities in Outcomes Following Peripheral Vascular Intervention.

Ramadan, Omar I / Santos, Tatiane / Stoecker, Jordan B / Belkin, Nathan / Jackson, Benjamin M / Schneider, Darren B / Rice, Jayne / Wang, Grace J

Annals of vascular surgery

2022 Volume 86, Page(s) 135–143

Abstract: Background: Peripheral artery disease (PAD) disproportionately affects nonwhite, Hispanic/Latino, and low socioeconomic status patients, who are less likely to have insurance and routine healthcare visits. Medicaid expansion (ME) has improved insurance ... ...

Abstract	Background: Peripheral artery disease (PAD) disproportionately affects nonwhite, Hispanic/Latino, and low socioeconomic status patients, who are less likely to have insurance and routine healthcare visits. Medicaid expansion (ME) has improved insurance rates and access to care, potentially benefitting these patients. We sought to assess the impact of ME on disparities in outcomes after peripheral vascular intervention (PVI) for PAD. Methods: A retrospective analysis of prospectively-collected Vascular Quality Initiative PVI procedures between 2011 and 2019 was conducted. The sample was restricted to first-record procedures in adults under the age 65 in states that expanded Medicaid on January 1, 2014 (ME group) or had not expanded before January 1, 2019 (non-expansion [NE] group). ME and NE groups were compared between pre-expansion (2011-2013) and post-expansion (2014- 2019) time periods to assess baseline demographic and operative differences. We used difference-in-differences multivariable logistic regression adjusted for patient factors and clinical center and year fixed effects. Our primary outcome was 1-year major amputation. Secondary outcomes included trends in presentation, 30-day mortality, 1-year mortality, and 1-year primary and secondary patency. Outcomes were stratified by race and ethnicity. Results: We examined 34,313 PVI procedures, including 20,378 with follow-up data. Rates of Medicaid insurance increased post-expansion in ME and NE states (ME 16.7% to 23.0%, P < 0.001; NE 10.0% to 11.9%, P = 0.013) while rates of self-pay decreased in ME states only (ME 4.6% to 1.8%, P < 0.001; NE 8.1% to 8.4%, P = 0.620). Adjusted difference-in-differences analysis revealed lower odds of urgent/emergent PVI among all patients and all nonwhite patients in ME states post-expansion compared to NE states (all: odds ratio [OR] 0.53 [95% confidence interval 0.33-0.87], P = 0.011; nonwhite: OR 0.41 [0.19-0.88], P = 0.023). No differences were observed for 1-year major amputation (OR 0.70 [0.43-1.14], P = 0.152), primary patency (OR 0.93 [0.63-1.38], P = 0.726), or secondary patency (OR 1.29 [0.69-2.41], P = 0.431). Odds of 1-year mortality were higher in ME states post-expansion compared to NE states (OR 2.50 [1.07-5.87], P = 0.035), although 30-day mortality was not different (OR 2.04 [0.60-6.90], P = 0.253). Notably, odds of 1-year major amputation among Hispanic/Latino patients decreased in ME states post-expansion compared to NE states (OR 0.11 [0.01-0.86], P = 0.036). Conclusions: ME was associated with lower odds of 1-year major amputation among Hispanic/Latino patients who underwent PVI for PAD. ME was also associated with lower odds of urgent/emergent procedures among patients overall and nonwhite patients specifically. However, 1-year mortality increased in the overall cohort. Further study is needed to corroborate our findings that ME may have benefits for certain underserved populations with PAD.
MeSH term(s)	Adult ; United States ; Humans ; Aged ; Medicaid ; Retrospective Studies ; Treatment Outcome ; Risk Factors ; Time Factors ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/surgery ; Insurance Coverage ; Healthcare Disparities
Language	English
Publishing date	2022-04-20
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2022.04.016
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Article ; Online: Socioeconomic characteristics of those with peripheral artery disease in the chronic renal insufficiency cohort.

Stoecker, Jordan B / Cohen, Jordana B / Belkin, Nathan / Chen, Jing C / Townsend, Raymond R / Xie, Dawei / Feldman, Harold I / Wang, Grace J

Vascular

2022 Volume 31, Issue 1, Page(s) 39–46

Abstract: Background: The association between socioeconomic factors and peripheral arterial disease (PAD) has not been as well characterized as other cardiovascular conditions. We sought to define how annual income and education level are associated with PAD in a ...

Abstract	Background: The association between socioeconomic factors and peripheral arterial disease (PAD) has not been as well characterized as other cardiovascular conditions. We sought to define how annual income and education level are associated with PAD in a well-characterized diverse set of adults with chronic kidney disease (CKD). Methods: The Chronic Renal Insufficiency Cohort Study (CRIC) is a multi-center, prospective cohort study designed to examine risk factors for progression of CKD and cardiovascular disease. Demographic, income, and education-level data, as well as clinical data including ankle-brachial index (ABI) were collected at baseline. Annual income was categorized as < $25,000, $25,000-50,000, $50,000-100,000, or above $100,000; educational level was categorized as some high school, high school graduate, some college, or college graduate. Participants with missing income data or incompressible ABI (>1.4) were excluded from initial analysis. Logistic regression was used to estimate the association of income and/or education level with PAD, defined as an enrollment ABI of <0.90, history of PAD, or history of PAD intervention. Results: A total of 4122 were included, mean age of participants was 59.5 years, 56% were male, and 44% were Black. There were 763 CRIC participants with PAD at study enrollment (18.5%). In the final multivariable logistic regression model, Black race (OR = 1.3, 95% CI 1.1-1.6, Conclusions: In this prospectively followed CKD cohort, lower annual household income and Black race were significantly associated with increased PAD at study enrollment. In contrast, educational level was not associated with PAD when adjusted for patient income data. Black race, female gender, and low income were independently associated with decreased statin use, populations which could be targets of future public health programs.
MeSH term(s)	Adult ; Humans ; Male ; Female ; Middle Aged ; Cohort Studies ; Prospective Studies ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/epidemiology ; Peripheral Arterial Disease/therapy ; Risk Factors ; Ankle Brachial Index/adverse effects ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/therapy ; Socioeconomic Factors
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors
Language	English
Publishing date	2022-03-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2137151-9
ISSN	1708-539X ; 1708-5381
ISSN (online)	1708-539X
ISSN	1708-5381
DOI	10.1177/17085381211053492
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Article ; Online: Failure to Rescue in Emergency Surgery: Is Precedence a Problem?

Hatchimonji, Justin S / Kaufman, Elinore J / Stoecker, Jordan B / Sharoky, Catherine E / Holena, Daniel N

The Journal of surgical research

2020 Volume 250, Page(s) 172–178

Abstract: Background: Mortality in emergency general surgery (EGS) is often attributed to patient condition, which may obscure opportunities for improvement in care. Identifying failure to rescue (FTR), or death after complication, may reveal these opportunities. ...

Abstract	Background: Mortality in emergency general surgery (EGS) is often attributed to patient condition, which may obscure opportunities for improvement in care. Identifying failure to rescue (FTR), or death after complication, may reveal these opportunities. FTR has been problematic in trauma secondary to low precedence rates (proportion of deaths preceded by complication). We sought to evaluate this in EGS, hypothesizing that precedence is lower in EGS than in similar elective operations. Methods: National Inpatient Sample data from January 2014 through September 2015 were used. 150,027 adult operative EGS complete cases were defined by emergent admission, one of seven International Classification of Diseases, ninth revision (ICD-9) procedure group codes for common EGS operations, and timing to operation (<48 h); these represent 750,135 patients under the National Inpatient Sample sampling design. Deaths were precedented if one of eight prespecified complications was identified. Chi-squared tests were used to compare precedence rates between selected emergent and elective operations. Results: There was a 2.5% mortality rate in this cohort of operative EGS patients, with an 84.1% (95% CI: 82.7%-85.4%) precedence rate. Among the seven listed procedure groups, those with clinically reasonable elective analogs were cholecystectomy, colon resection, and laparotomy. Emergent versus elective precedence rates were 90.2% versus 82.0% (P = 0.004) for colon resection, 81.3% versus 86.8% (P = 0.26) for cholecystectomy, and 68.8% versus 92.7% (P < 0.001) for laparotomy. Conclusions: Precedence rates in EGS were higher than expected and were similar to previously published rates in nonemergent surgery, suggesting that FTR is likely to be reliable using standard methodology. Management of complications after emergency operation may represent significant opportunities to prevent mortality.
MeSH term(s)	Elective Surgical Procedures/statistics & numerical data ; Emergency Service, Hospital/organization & administration ; Emergency Service, Hospital/statistics & numerical data ; Emergency Treatment/statistics & numerical data ; Failure to Rescue, Health Care/statistics & numerical data ; Hospital Mortality ; Humans ; Postoperative Complications/etiology ; Postoperative Complications/mortality ; Quality Improvement ; Retrospective Studies
Language	English
Publishing date	2020-03-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2019.12.051
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Article ; Online: The Association Between Socioeconomic Factors and Incident Peripheral Artery Disease in the Chronic Renal Insufficiency Cohort (CRIC).

Stoecker, Jordan B / Cohen, Jordana B / Belkin, Nathan / Chen, Jing C / Townsend, Raymond R / Xie, Dawei / Feldman, Harold I / Wang, Grace J

Annals of vascular surgery

2021 Volume 80, Page(s) 196–205

Abstract: Background: The association between socioeconomic factors and development of peripheral artery disease (PAD) has not been as well characterized compared to other cardiovascular diseases. We sought to define how annual income, sex, race, and education ... ...

Abstract	Background: The association between socioeconomic factors and development of peripheral artery disease (PAD) has not been as well characterized compared to other cardiovascular diseases. We sought to define how annual income, sex, race, and education level are associated with newly diagnosed PAD in a well-characterized, diverse set of adults with CKD. Methods: The Chronic Renal Insufficiency Cohort Study (CRIC) is a multicenter, prospective cohort study designed to examine risk factors for progression of CKD and cardiovascular disease. Demographic and clinical data including ankle brachial index (ABI) and interventions were collected at baseline, as well as yearly during follow-up visits. Annual income was categorized as: <$25,000, $25,000-50,000, $50,000-100,000, or above $100,000. We excluded those with pre-existing PAD, defined as enrollment ABI of <0.9 or >1.4, or missing income data. Cox proportional hazards regression was used to estimate the risk for incident PAD during CRIC enrollment, defined as a drop in ABI to <0.90 or a confirmed PAD intervention, including revascularization or amputation. Results: A total of 3,313 patients met inclusion criteria, the mean age was 58.7 years, 56% were male, and 42% were Black. Over a median follow-up of 10.1 years, 639 participants (19%) were newly diagnosed with PAD. After adjusting for cardiovascular risk factors, all lower levels of annual household income were associated with increased incidence of PAD (income <$25,000 HR 1.7, 95% CI 1.1-2.4, P = 0.008; income $25,000-50,000 HR 1.5, 95% CI 1.1-2.3, P = 0.009; income $50,000-100,000 HR 1.6, 95% CI 1.2-2.4, P = 0.004), relative to a baseline annual income of >$100,000 (overall P-value = 0.02). In the multivariable model, there was no association between education level and PAD incidence (P = 0.80). Black race (HR 1.2, 95% CI 1.0-1.5, P = 0.023) and female sex (HR 1.7, 95% CI 1.4-2.0, P < 0.001) were independently associated with PAD incidence. Multiple imputation analysis provided similar results. Conclusions: In the CRIC, a multi-center cohort of prospectively followed CKD patients undergoing yearly CVD surveillance, lower annual household income, female sex, and Black race were significantly associated with the PAD incidence. In contrast, level of education was not independently associated with incident PAD.
MeSH term(s)	Adult ; Black or African American ; Aged ; Ankle Brachial Index ; Female ; Humans ; Incidence ; Income ; Male ; Middle Aged ; Peripheral Arterial Disease/epidemiology ; Peripheral Arterial Disease/etiology ; Prospective Studies ; Renal Insufficiency, Chronic/complications ; Risk Factors ; Sex Factors ; Socioeconomic Factors
Language	English
Publishing date	2021-10-14
Publishing country	Netherlands
Document type	Journal Article ; Multicenter Study
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2021.07.057
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