OBJECTIVE: @entity3657 ( @entity3657 ) afflicts up to 20% of older @entity1 and is associated with a high risk of cardiovascular (CV) morbidity, but a rather low risk of progression of leg symptoms. These risk estimations are largely taken from cohort studies performed 20 years ago. To test the validity of this, available data were systematically reviewed and attempts were made to perform meta-analyses of CV risk and disease progression. METHODS: A database literature search was conducted of the period 1990-2015 using related subject headings. Inclusion criteria were cohort studies for @entity3657 , sample size >100 subjects, follow up time >= 1 year, and studies presenting endpoints covering mortality and/or CV events. Analyses were performed for a reference population, as well as groups with @entity10094 ( @entity10094 ), symptomatic @entity3657 , and subjects with ankle brachial index <0.9. RESULTS: Of 354 identified articles, 35 were eligible for systematic review. Sample size varied between 109 and 16,440 subjects. Mean age in the cohorts ranged from 56 to 81 years (SD 10.8) and mean follow up was 6.3 years (range 1-13). Most included @entity1 with symptomatic @entity3657 had @entity2337 (91%). Symptomatic @entity3657 subjects had higher 5 year cumulative CV mortality than the reference population, 13% versus 5%. During follow up, approximately 7% of @entity10094 @entity1 progressed to @entity2337 , and 21% of @entity2337 @entity1 were diagnosed as having @entity63 , with 4-27% undergoing amputations. CONCLUSION: The risk to the limb is underestimated in @entity3657 @entity1 , whereas the CV related morbidity is more moderate than stated in the guidelines. The latter observation is especially valid for @entity2337 @entity1 . These findings should be considered when evaluating @entity1 for treatment.

The Risk of Disease Progression in @entity3657 is Higher than Expected: A Meta-Analysis of Mortality and Disease Progression in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'people'] @entity3657 :: ('MESH:D058729', 'Disease') :: ['Peripheral arterial disease', 'PAD'] @entity63 :: ('MESH:D007511', 'Disease') :: ['critical limb ischemia'] @entity2337 :: ('MESH:C537984', 'Disease') :: ['IC'] @entity10094 :: ('MESH:D058070', 'Disease') :: ['APAD', 'asymptomatic PAD']
@entity3657 :: (MESH:D058729,Disease) :: ['Peripheral Arterial Disease']
