Association between health status and long‐term mortality after percutaneous revascularization of peripheral artery disease

Bunte, Matthew C.; House, John A.; Spertus, John A.; Cohen, David J.; Marso, Steven P.; Safley, David M.

doi:10.1002/ccd.26442

Cited by 10 publications

(5 citation statements)

References 30 publications

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“…Several studies have indicated that diabetes is a predictor of poor outcomes following such procedures with poorer patency rates 8 and cardiovascular outcomes. 9,10 However, other studies suggested that diabetics have similar outcomes to nondiabetics following stenting 11 or atherectomy (directional 12 or rotational 13 ) despite more advanced comorbidities. In these studies, and after adjusting for multiple comorbidities, diabetics had a similar patency rate, freedom from target lesion revascularization and clinical improvement compared with nondiabetics.…”

Section: Introductionmentioning

confidence: 99%

Major Limb Outcomes Following Lower Extremity Endovascular Revascularization in Patients With and Without Diabetes Mellitus

Shammas

Jeon–Slaughter

Tsai³

et al. 2017

J Endovasc Ther

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Section: Introductionmentioning

confidence: 99%

Major Limb Outcomes Following Lower Extremity Endovascular Revascularization in Patients With and Without Diabetes Mellitus

Shammas

Jeon–Slaughter

Tsai³

et al. 2017

J Endovasc Ther

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“…On the other hand, when successful, the revascularization procedure in PAD patients, in addition to improving functional status, significantly reduces the occurrence of future major cardiovascular events by approximately four times [ 35 ]. Moreover, the revascularization procedures, enhancing patients’ mobility [ 36 ], improved their prognosis and survival probability at the intermediate PAD stages [ 37 , 38 ], although not in patients with critical limb ischemia [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

To Treat or not to Treat? The Fate of Patients with Intermittent Claudication Following Different Therapeutic Options

Tsolaki,

Traina,

Savriè

et al. 2024

Rev. Cardiovasc. Med.

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Background: Peripheral artery disease (PAD) is recognized as a significant contributor to the public health burden in the cardiovascular field and has a significant rate of morbidity and mortality. In the intermediate stages, exercise therapy is recommended by the guidelines, although supervised programs are scarcely available. This single-center observational study aimed to evaluate the long-term outcomes of patients with PAD and claudication receiving optimal medical care and follow-up or revascularization procedures or structured home-based exercise. Methods: The records of 1590 PAD patients with claudication were assessed at the Vascular Surgery Unit between 2008 and 2017. Based on the findings of the recruitment visit, patients were assigned to one of the three following groups according to the available guidelines: Revascularization (Rev), structured exercise therapy (Ex), or control (Co). The exercise program was prescribed at the hospital and executed at home with two daily 10-minute interval walking sessions at a pain-free speed. The number and date of deaths, all-cause hospitalizations, and peripheral revascularizations for 5 years were collected from the Emilia-Romagna regional database. Results: At entry, 137 patients underwent revascularization; 1087 patients were included in the Ex group, and 366 were included in the Co group. At baseline, patients in the Rev group were significantly younger and had fewer comorbidities ( p 0.001). A propensity score matching analysis was performed, and three balanced subgroups of 119 patients were each created. The mortality rate was significantly ( p 0.001) greater in the Co (45%) group than in the Rev (11%) and Ex (11%) groups, as was the incidence of all-cause hospitalizations (Co: 95%; Rev 56%; Ex 60%; p 0.001). There were no differences in peripheral revascularizations (Co: 19%; Rev: 17%; Ex 11%). Conclusions: In PAD patients with claudication, both revascularization procedures and structured home-based exercise sessions are associated with better long-term clinical outcomes than walking advice and follow-up only.

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“…Apart from the obvious reduced functional capacity, PAD patients experience high rates of cardiovascular (CVD) morbidity and mortality, especially those with chronic, low-grade inflammation, such as diabetes mellitus and obesity [ 2 ]. Revascularization of lower-limb arteries has been associated with better long-term survival and quality of life when the patency of the arteries is maintained [ 3 ]. However, the restenosis rate and the post-intervention occurrence of major adverse cardiovascular events (MACE) is still high despite the advances in revascularization techniques and the optimal pharmaceutical therapy [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The prognostic role of RBP-4 and adiponectin in patients with peripheral arterial disease undergoing lower limb endovascular revascularization

Kadoglou

Korakas

Karkos

et al. 2021

Cardiovasc Diabetol

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Background RBP4 is an adipokine with an established role in atherosclerosis, while adiponectin has unique anti-inflammatory properties. We investigated the association of RBP4 and adiponectin with the presence of symptomatic peripheral artery disease (PAD) and their possible prognostic role in major adverse cardiovascular events (MACE). Methods We enrolled 168 consecutive patients with symptomatic, established PAD, requiring revascularization by endovascular means of any or both of their lower limbs. 88 age- and sex-matched subjects with less than 2 classical cardiovascular risk factors served as controls. Clinical parameters, glycemic and lipid profile, RBP4 and adiponectin levels were assayed. The occurrence of MACE was recorded during the 6-month follow-up and patients were assigned to MACE and non-MACE subgroups. Results The presence of symptomatic PAD was significantly correlated with age, diabetes, hsCRP, RBP4 and low adiponectin levels (p < 0.05). After adjustment for age, RBP4 (β = 0.498, p < 0.001), and adiponectin (β = –0.288, p < 0.001) levels remained as independent predictors of PAD presence in the whole study cohort. At baseline, MACE subgroup appeared with higher RBP-4 and hsCRP serum levels than non-MACE subgroup (p < 0.001), but no differences were detected for adiponectin (p = 0.758). Serum RBP4 levels remained independent predictor of MACE (β = 0.455, p < 0.001) after adjustment for traditional cardiovascular risk factors. Conclusions High RBP4 and low adiponectin serum levels are independently associated with PAD presence. In addition, RBP4 is an independent predictor of MACE incidence in symptomatic PAD patients.

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Association between health status and long‐term mortality after percutaneous revascularization of peripheral artery disease

Cited by 10 publications

References 30 publications

Major Limb Outcomes Following Lower Extremity Endovascular Revascularization in Patients With and Without Diabetes Mellitus

Major Limb Outcomes Following Lower Extremity Endovascular Revascularization in Patients With and Without Diabetes Mellitus

To Treat or not to Treat? The Fate of Patients with Intermittent Claudication Following Different Therapeutic Options

The prognostic role of RBP-4 and adiponectin in patients with peripheral arterial disease undergoing lower limb endovascular revascularization

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