Adverse Prognosis of Peripheral Artery Disease Treatments Associated With Diabetes: A Comprehensive Meta-Analysis

Angiology ◽  
2021 ◽  
pp. 000331972110424
Author(s):  
Jingyang Luan ◽  
Jie Xu ◽  
Weiquan Zhong ◽  
Yan Zhou ◽  
Hao Liu ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Meta Analysis ◽  
Primary Patency ◽  
Secondary Patency ◽  
Peripheral Artery ◽  
Secondary Endpoints ◽  
Artery Disease ◽  
Long Term Mortality

Many studies have investigated the influence of diabetes mellitus (DM) on outcomes in patients with peripheral artery disease (PAD). We performed a meta-analysis of the outcomes of PAD treatments in DM patients compared with those without DM. Long-term mortality was the primary endpoint. Secondary endpoints were in-hospital/30-day mortality, primary/secondary patency, amputation, and limb salvage. Thirty-one studies reporting 58113 patients were eligible for enrollment. The mean follow-up duration ranged from 1 to 89 months. DM was significantly associated with long-term mortality (relative risk (RR) = 1.67; 95% confidence intervals (CI), 1.43–1.94; P < .001). DM was also associated with significantly lower primary patency (RR = 0.74; 95% CI, 0.58–0.95; P = .001) and secondary patency (RR = 0.80; 95% CI, 0.67–0.96; P = .009). DM is associated with worse outcomes and adverse prognosis of treatment in patients with PAD, and may therefore be a modifiable risk factor for poor prognosis in PAD patients.

Statins and Major Adverse Limb Events in Patients with Peripheral Artery Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 120 (05) ◽  
pp. 866-875 ◽  
Author(s):  
Daniele Pastori ◽  
Alessio Farcomeni ◽  
Alberto Milanese ◽  
Francesco Del Sole ◽  
Danilo Menichelli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Artery Disease ◽  
Meta Analysis ◽  
Graft Occlusion ◽  
Peripheral Artery ◽  
All Cause Mortality ◽  
Statin Prescription ◽  
Secondary Endpoints ◽  
Artery Disease ◽  
The Impact

Abstract Background Statins are guidelines recommended in patients with peripheral artery disease (PAD) for the prevention of cardiovascular (CV) events. Comprehensive meta-data on the impact of statins on major adverse limb events (MALE) in PAD patients are lacking. We examined the association of statin use with MALE in patients with PAD. Methods We performed a systematic review (registered at PROSPERO: number CRD42019137111) and metanalysis of studies retrieved from PubMed (via MEDLINE) and Cochrane (CENTRAL) databases addressing the impact of statin on MALE including amputation and graft occlusion/revascularization. Secondary endpoints were all-cause death, composite CV endpoints, CV death, and stroke. Results We included 51 studies with 138,060 PAD patients, of whom 48,459 (35.1%) were treated with statins. The analysis included 2 randomized controlled trials, 20 prospective, and 29 retrospective studies. Overall, 11,396 MALE events, 21,624 deaths, 4,852 composite CV endpoints, 4,609 CV deaths, and 860 strokes were used for the analysis. Statins reduced MALE incidence by 30% (pooled hazard ratio [HR]: 0.702; 95% confidence interval [CI]: 0.605–0.815) and amputations by 35% (HR: 0.654; 95% CI: 0.522–0.819), all-cause mortality by 39% (pooled HR: 0.608, 95% CI: 0.543–0.680), CV death by 41% (HR: 0.594; 95% CI: 0.455–0.777), composite CV endpoints by 34% (pooled HR: 0.662; 95% CI: 0.591–0.741) and ischemic stroke by 28% (pooled HR: 0.718; 95% CI: 0.620–0.831). Conclusion Statins reduce the incidence of MALE, all-cause, and CV mortality in patients with PAD. In PAD, a high proportion of MALE events and deaths could be prevented by implementing a statin prescription in this patient population.

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

2016 ◽  
Vol 87 (6) ◽  
pp. 1149-1155 ◽  
Author(s):  
Matthew C. Bunte ◽  
John A. House ◽  
John A. Spertus ◽  
David J. Cohen ◽  
Steven P. Marso ◽  
...  
Keyword(s):  
Health Status ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Percutaneous Revascularization ◽  
Long Term Mortality

Association of peripheral artery disease and long-term mortality in hemodialysis patients

2010 ◽  
Vol 44 (2) ◽  
pp. 569-573 ◽  
Author(s):  
Shigeru Otsubo ◽  
Mariko Kitamura ◽  
Takako Wakaume ◽  
Aiji Yajima ◽  
Miwa Ishihara ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Hemodialysis Patients ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Long Term Mortality

Abstract 3312: Cilostazol Improves Long-term Patency after Percutaneous Transluminal Angioplasty in Hemodialysis Patients with Peripheral Artery Disease

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Yoshitaka Kumada ◽  
Hideki Ishii ◽  
Toru Aoyama ◽  
Miho Tanaka ◽  
Takanobu Toriyama ◽  
...  
Keyword(s):  
Propensity Score ◽  
Peripheral Artery Disease ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Primary Patency ◽  
Control Group ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Percutaneous Transluminal

Background: Percutaneous transluminal angioplasty (PTA) has become common therapeutic standard for peripheral artery disease (PAD). Although initial success rate of PTA is high, higher restenosis rate is a limitation in hemidialysis (HD) patients. Cilostazol is a PDE3 inhibitor with anti-platelet and vasodilatory effects, and also inhibits the proliferation of the smooth muscle cells, and has been reported to reduce target lesion revascularization (TLR) in PAD patients. The aim of this study was to clarify the effects of cilostazol administration for long-term patency after PTA in HD patients. Methods: Consecutive 372 lesions of 193 HD patients undergoing successfully PTA were enrolled. They were divided into two groups; patients administered cilostazol (130 lesions of 71 patients) and those without cilostazol as a control (242 lesions of 122 patients). They were followed-up using Doppler ultrasound and/or angiography for 5 years. To minimize the selection bias for cilostazol administration, a propensity-matched analysis using the model including male, age, diabetes, critical limb ischemia (CLI), TASC C+D type, femoropopoliteal (FPA) lesion and stenting was performed. The propensity score was matched 1:1 with two-digit (AUC=0.69 using ROC analysis). Results: Mean follow-up period was 28±24months. Primary patency rate for 5 years was significantly higher in the cilostazol group than in the control group (53% vs 33%, p = 0.0003). Also, rates for freedom from TLR and for limb salvage were higher in cilostazol group than in control group (67% vs. 50%, p=0.011 and 88% vs. 72%, p =0.031, respectively). In 102 lesions matched after propensity score analysis, the primary patency for 5-year was significantly higher in the cilostazol group (58%) than in the control group (35%) (HR 0.48, 95%CI 0.30 – 0.76, p = 0.0017). Upon multivariate Cox analysis, Cilostazol (HR 0.50, 95%CI 0.26 – 0.87, p = 0.014), age (HR 1.03, 95%CI 1.01–1.07, p = 0.041), FPA lesion (HR 2.62, 95%CI 1.22–5.62, p = 0.013), TASC C+D type (HR 2.85, 95%CI 1.56 –5.20, p = 0.0006) and CLI (HR 4.09, 95%CI 2.10 –7.94, p <0.0001) were independent predictors of restenosis after PTA. Conclusion: These data suggest that cilostazol administration improves long-term patency after PTA in HD Patients with PAD.

scholarly journals Bilateral low systolic toe pressure and toe-brachial index are associated with long-term mortality in patients with peripheral artery disease

2019 ◽  
Vol 70 (6) ◽  
pp. 1994-2004 ◽  
Author(s):  
Jan-Erik Wickström ◽  
Juha Virtanen ◽  
Ellinoora Aro ◽  
Juho Jalkanen ◽  
Maarit Venermo ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Toe Brachial Index ◽  
Artery Disease ◽  
Toe Pressure ◽  
Long Term Mortality

scholarly journals Association of Perceived Stress Levels With Long-term Mortality in Patients With Peripheral Artery Disease

2020 ◽  
Vol 3 (6) ◽  
pp. e208741 ◽  
Author(s):  
Ali O. Malik ◽  
Poghni Peri-Okonny ◽  
Kensey Gosch ◽  
Merrill Thomas ◽  
Carlos Mena ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Perceived Stress ◽  
Peripheral Artery ◽  
Stress Levels ◽  
Artery Disease ◽  
Long Term Mortality
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