Peripheral artery disease patients may benefit more from aggressive secondary prevention than aneurysm patients to improve survival

Abstract

a b s t r a c tBackground and aims: Although it has become clear that aneurysmal and occlusive arterial disease represent two distinct etiologic entities, it is still unknown whether the two vascular pathologies are prognostically different. We aim to assess the long-term vital prognosis of patients with abdominal aortic aneurysmal disease (AAA) or peripheral artery disease (PAD), focusing on possible differences in survival, prognostic risk profiles and causes of death. Methods: Patients undergoing elective surgery for isolated AAA or PAD between 2003 and 2011 were retrospectively included. Differences in postoperative survival were determined using Kaplan-Meier and Cox regression analysis. Prognostic risk profiles were also established with Cox regression analysis. Results: 429 and 338 patients were included in the AAA and PAD groups, respectively. AAA patients were older (71.7 vs. 63.3 years, p < 0.001), yet overall survival following surgery did not differ (HR: 1.16, 95% CI: 0.87e1.54). Neither was type of vascular disease associated with postoperative cardiovascular nor cancer-related death. However, in comparison with age-and gender-matched general populations, cardiovascular mortality was higher in PAD than AAA patients (48.3% vs. 17.3%). Survival of AAA and PAD patients was negatively affected by age, history of cancer and renal insufficiency. Additional determinants in the PAD group were diabetes and ischemic heart disease. Conclusions: Long-term survival after surgery for PAD and AAA is similar. However, overall life expectancy is significantly worse among PAD patients. The contribution of cardiovascular disease towards mortality in PAD patients warrants more aggressive secondary prevention to reduce cardiovascular mortality and improve longevity.

Critical limb ischemia patients clinically improving with medical treatment have lower neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios

“…13 Patients recovering from CLI are freed from the overproduction of cytokines, an indirect reflection of which is their NLR and PLR levels. Secondary prevention in PAD patients has prognostic and economic benefits compared to treating patients in the late stages of disease 33 and in this context, the role of anti-inflammatory treatment in secondary prevention can be a focus of future research.…”

Factors Influencing on the Mortality in Patients With Obliterating Diseases of Lower Limb Arteries

“…На первый взгляд, неожиданным в настоящей ра-боте оказалось отсутствие влияния получаемой тера-пии на прогноз больных ОЗАНК, что расходится с данными литературы [11,20]. Действительно, пока-зано, что прием статинов у данной категории пациен-тов не только снижает число таких осложнений как кардиоваскулярная смерть, нефатальные инфаркт миокарда (ИМ) или инсульт (р=0,01), но и общую смертность (р=0,014).…”