Home > Riviste > International Angiology > Fascicoli precedenti > International Angiology 2016 October;35(5) > International Angiology 2016 October;35(5):516-25

ULTIMO FASCICOLO
 

ARTICLE TOOLS

Estratti
Per citare questo articolo

INTERNATIONAL ANGIOLOGY

Rivista di Angiologia


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,37


eTOC

 

ORIGINAL ARTICLES  


International Angiology 2016 October;35(5):516-25

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Long-term mortality after invasive diagnostic and endovascular revascularization in PAD patients

Eva M. BROICH, Holger REINECKE, Nasser M. MALYAR, Matthias MEYBORG, Katrin GEBAUER

Division of Vascular Medicine, Department of Cardiovascular Medicine, University of Muenster, Muenster, Germany


PDF  


BACKGROUND: The aim of this study was to assess the long-term, all-cause mortality among PAD patients hospitalized for invasive diagnostics and/or endovascular revascularization (ER) and the applied secondary prevention management.
METHODS: From 2005 to 2009, at our center 582 consecutive patients underwent invasive peripheral angiography in part in combination with coronary angiography and/or ER. Patients were classified according to their Fontaine stage into 3 subgroups: Fontaine I/IIa, Fontaine IIb, and Fontaine stages III and IV (which were classified as critical limb ischemia, CLI). Demographic and clinical data were retrospectively obtained and patients followed up.
RESULTS: Mean age increased with higher Fontaine stages (P=0.009). The proportion of patients with diabetes and anemia was lowest in Fontaine stage IIb and highest in CLI (each p<0.001). The cumulative all-cause mortality during follow-up was 17% in Fontaine stage I/IIa, 22% in Fontaine stage IIb and 34% in CLI, respectively (P<0.001). In multivariate cox regression models including diabetes mellitus, gender, age, creatinine and baseline hemoglobin, patients with Fontaine stage IIb had a 1.4-fold (95%CI 0.60-3.16) and those with CLI a 2.3-fold (95%CI 1.03-5.08) increased mortality compared to Fontaine stage I/IIa. At baseline, patients with CLI received significantly less beta blocker, statins, ACE or AT1 inhibitors and less anticoagulants; at follow-up only statins were significantly less often prescribed to CLI patients (all p<0.05). Univariate analyses showed that a therapy with statins (HR 0.64; CI 0.43-0.96; P=0.03) and antiplatelet/anticoagulant agents (HR 0.5; CI 0.27-0.94; P=0.03) significantly reduced mortality.
CONCLUSIONS: Long-term mortality in CLI patients doubles the rate in patients with Fontaine stage I/IIa. Non-adherence to evidence-based recommendations and guidelines such as inadequate use of cardioprotective drugs might contribute to the observed high mortality rates in patients with CLI.

inizio pagina

Publication History

Per citare questo articolo

Broich EM, Reinecke H, Malyar NM, Meyborg M, Gebauer K. Long-term mortality after invasive diagnostic and endovascular revascularization in PAD patients. Int Angiol 2016 October;35(5):516-25. 

Corresponding author e-mail

e.bro@me.com