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Prevalence of peripheral arterial disease in subjects with moderate cardiovascular risk: Italian results from the PANDORA study Data from PANDORA (Prevalence of peripheral Arterial disease in subjects with moderate CVD risk, with No overt vascular Diseases nor Diabetes mellitus)

Guido Sanna1*, Donatella Alesso1, Malek Mediati1, Claudio Cimminiello2, Claudio Borghi3, Amalia Lucia Fazzari4, Mario Mangrella5 and the PANDORA study investigators

Author Affiliations

1 METIS Scientific Association of Italian Family Doctors, Roma, Italy

2 Department of Medicine, Vimercate Hospital, Italy

3 Department of Internal Medicine, S.Orsola-Malpighi Hospital, Bologna University, Italy

4 Department of Economics and Territory, University of Rome "Tor Vergata", Italy

5 R&D Department, AstraZeneca SpA, Milan, Italy

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BMC Cardiovascular Disorders 2011, 11:59  doi:10.1186/1471-2261-11-59

Published: 7 October 2011



The PANDORA study has recently examined the prevalence of low ankle brachial index (ABI) in subjects with moderate risk of cardiovascular disease. This sub-analysis of the PANDORA study examines the prevalence of asymptomatic peripheral arterial disease (PAD), as determined by ABI, in Italian subjects presenting with moderate cardiovascular risk, in the absence of diabetes or overt vascular disease.


PANDORA is a non-interventional, cross-sectional study that was performed in 6 European countries, involving subjects with at least one cardiovascular (CV) risk factor. The primary objective was to evaluate the prevalence of asymptomatic PAD using ABI. For this post-hoc sub-analysis, data were extracted for subjects enrolled in Italy, comprising 51.5% (n = 5298) of subjects from the original PANDORA study. Secondary objectives were to establish the prevalence and treatment of CV risk factors.


The mean age was 63.9 years and 22.9% (95% CI 21.7-24.0) of subjects presented with asymptomatic PAD. A range of risk factors comprising smoking, hypertension, low HDL-cholesterol, family history of coronary heart disease and habit of moderate-high alcohol intake were significantly associated with asymptomatic PAD (p < 0.0001). Statin treatment had the lowest incidence in Italian subjects. Furthermore, patients treated with statins were significantly less likely to have asymptomatic PAD than those who were not (p = 0.0001).


Asymptomatic PAD was highly prevalent in Italian subjects, the majority of whom were not candidates for ABI assessment according to current guidelines. Findings from this study suggest that these patients should be carefully examined in clinical practice and ABI measured so that therapeutic interventions known to decrease their CV risk may be offered.

Trial registration number NCT00689377

Peripheral vascular disease; ankle-brachial index; atherosclerosis; risk factors; prevention