New research from Intermountain Health in Salt Lake City indicates that patients diagnosed with peripheral arterial disease (PAD) who also have atrial fibrillation (AFib) experience a significantly higher risk of major adverse cardiovascular events (MACE). The study analyzed long-term data from Intermountain Health patients, revealing that AFib is present in approximately one in four individuals with PAD, a finding that highlights a concerning and previously underrecognized link between these two conditions.
The research discovered that the presence of AFib nearly doubles the risk of MACE in patients compared to those with PAD alone. AFib, the most common type of irregular heart rhythm, can lead to various symptoms including palpitations, fatigue, and shortness of breath. This condition occurs when the heart’s upper chambers, known as atria, do not coordinate properly with the lower pumping chambers, called ventricles. AFib can increase the likelihood of blood clots forming in the heart, thereby raising the risk of stroke and other heart-related complications.
PAD itself affects an estimated 8 to 12 million adults in the United States. It occurs when arteries in the extremities, particularly the legs, become narrowed due to plaque buildup, limiting blood flow. This restriction may cause pain during physical activities, a condition known as claudication. While treatments for both coronary artery disease (CAD) and PAD include lifestyle changes such as exercise and a healthy diet, individuals with PAD face a higher risk of heart attacks, strokes, and even amputations. The presence of AFib further amplifies these risks.
Viet Le, DMSc, MPAS, PA-C, an advanced practice clinician and cardiovascular researcher at Intermountain Health, served as the principal investigator for the study. Le emphasized the implications of the findings, stating, “This is a stark reminder that PAD is not just a limb-threatening disease—it’s a marker of widespread atherosclerosis. When atrial fibrillation is added to the mix, the risk of heart attack, stroke, and death escalates significantly. Clinicians must screen for AFib in PAD patients and aggressively manage both conditions.”
Key Findings and Implications
The study’s findings highlight a critical need for improved adherence to screening and treatment protocols for patients with PAD and AFib. Despite established guidelines, only 35% of PAD patients receive optimal medical therapy, which includes managing blood pressure, prescribing statins, providing aspirin therapy, and offering smoking cessation support.
Le observed, “Both conditions derive from plaque buildup in femoral and arterial arteries. Atrial fibrillation should be assessed in all peripheral arterial disease patients, and aggressive preventative treatment should be implemented.” This call to action aims to enhance the quality of care for patients at risk and ultimately reduce the incidence of cardiovascular events associated with these interconnected conditions.
The interrelationship between PAD and AFib underscores the necessity for healthcare providers to be vigilant in screening and managing these risks. With a growing patient population affected by both conditions, the findings of this study serve as a crucial reminder of the systemic health risks associated with cardiovascular diseases.