Peripheral Artery Disease Prognosis and Outcomes: Scoping Review with ☸️SAIMSARA.

Name: SAIMSARA Evidence Object vascular::PAD_OUTCOME_PM
Creator: SAIMSARA
License: https://saimsara.com/license/

SAIMSARA

doi:10.62487/saimsara9e1c0fc3r

SAIMSARA Journal

Machine-Readable Science • ISSN 3054-3991

Peripheral Artery Disease Prognosis and Outcomes: Scoping Review with ☸️SAIMSARA.

Cardiac & Vascular Health

Issue 1, Volume 1, 2026

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DOI: 10.62487/saimsara9e1c0fc3r

Editorial note

• Last update: 2026-05-04 12:58:10

What is this paper about

PAD is not just a leg-artery disease — it is a powerful warning sign for future death, cardiovascular events, limb loss, and frailty. This review maps which signals matter most for prognosis, from MALE, polyvascular disease, diabetes and CKD to biomarkers, nutrition scores, exercise capacity, and machine-learning risk prediction.

Human-verified editorial review Verified by World ID proof-of-human. This editorial layer was submitted from a SAIMSARA account verified as a unique human.

Abstract: The aim of this paper is to synthesize current evidence regarding the prognostic factors and clinical outcomes associated with peripheral artery disease, focusing on mortality, limb loss, and the predictive utility of emerging biomarkers and clinical scoring systems. The review utilises 373 original studies with 10030675 total participants (topic deduplicated ΣN). Across the mapped evidence, PAD emerged as a strong and consistent prognostic signal for both systemic and limb outcomes, with all-cause mortality hazard ratios ranging from 1.15 to 3.23 and a stepwise mortality gradient reaching 35–42.9% in triple-territory polyvascular disease. Major adverse limb events functioned as sentinel events, associated with markedly higher subsequent hospitalization (HR 7.21) and death (HR 3.23), while low-dose rivaroxaban plus aspirin was associated with a 43% MALE reduction in lower-extremity PAD and reduced acute limb ischemia after lower-extremity revascularization. Recurrent topic-level signals support a role for nutritional indices (GNRI, PNI), cardiac biomarkers (hs-cTnT, NT-proBNP, GDF15), inflammation-based ratios, frailty/sarcopenia, and ABI-related measures as prognostic refiners beyond traditional vascular indices, and machine-learning multi-marker panels achieved AUROC values around 0.80–0.88 for 2–3-year MALE prediction. Practically, the evidence map indicates that PAD prognosis is best approached as a multidimensional problem integrating intensified antithrombotic therapy, secondary prevention, comorbidity control (diabetes, CKD, heart failure), and structured exercise rehabilitation rather than reliance on anatomic severity alone. Heterogeneity in outcome definitions, biomarker thresholds, and the unresolved obesity paradox remain key uncertainties within the mapped literature. Future research should prioritize prospective external validation of multi-protein and machine-learning prognostic models against harmonized MALE/MACE endpoints, alongside trials testing whether biomarker- and nutrition-guided risk stratification improves long-term survival and limb preservation in PAD.

Keywords: Peripheral Artery Disease; Major Adverse Limb Events; All-Cause Mortality; Prognostic Biomarkers; Risk Stratification; Major Adverse Cardiovascular Events; Endovascular Revascularization; Polyvascular Disease; Cardiovascular Death; Disease Severity

Review Stats

Final search date and database lock: 2026-05-04 14:26:27 CEST
Plan: Pro (expanded craft tokens; source: PubMed)
Source: PubMed
Total Abstracts/Papers: 997
Downloaded Abstracts/Papers: 997
Included original and non-original Abstracts/Papers (all): 390
Included original Abstracts/Papers (Vote counting by direction of effect): 373
Reference Index (links used in paper): 139
Total participants (topic deduplicated ΣN): 10030675

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Reference Index (139)

[1] Major Adverse Limb Events and Mortality in Patients With Peripheral Artery Disease: The COMPASS Trial. — https://doi.org/10.1016/j.jacc.2018.03.008
[2] The Prognostic Value of Peripheral Artery Disease in Heart Failure: Insights from a Meta-analysis. — https://doi.org/10.1016/j.hlc.2016.04.002
[3] C-reactive protein-to-albumin ratio in peripheral artery disease. — https://doi.org/10.1515/med-2025-1280
[4] Fatty acid binding protein 4 has prognostic value in peripheral artery disease. — https://doi.org/10.1016/j.jvs.2023.05.001
[5] Trimethylamine-N-Oxide (TMAO) Predicts Cardiovascular Mortality in Peripheral Artery Disease. — https://doi.org/10.1038/s41598-019-52082-z
[6] Adverse Prognosis of Peripheral Artery Disease Treatments Associated With Diabetes: A Comprehensive Meta-Analysis. — https://doi.org/10.1177/00033197211042494
[7] Prognostic Role of Polyvascular Involvement in Patients with Symptomatic Peripheral Artery Disease. — https://doi.org/10.3390/jcm12103410
[8] Prognostic Impact of Interleukin-27 in Peripheral Artery Disease. — https://doi.org/10.3390/life15111768

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