Effects of successful percutaneous lower extremity revascularization on cardiovascular outcome in patients with peripheral arterial disease

Item Type:	Article
Title:	Effects of successful percutaneous lower extremity revascularization on cardiovascular outcome in patients with peripheral arterial disease
Creators Name:	Giugliano, G. and Di Serafino, L. and Perrino, C. and Schiano, V. and Laurenzano, E. and Cassese, S. and De Laurentis, M. and Schiattarella, G.G. and Brevetti, L. and Sannino, A. and Gargiulo, G. and Franzone, A. and Indolfi, C. and Piscione, F. and Abdelilah-Seyfried, S. and Esposito, G.
Abstract:	BACKGROUND: Lower extremity peripheral arterial disease (LE-PAD) reduces walking capacity and is associated with an increased cardiovascular risk. Endovascular revascularization of LE-PAD improves walking performance and quality of life. In the present study, we determined whether successful lower limbs revascularization also impacts cardiovascular outcome in LE-PAD patients. METHODS: 479 consecutive LE-PAD patients at stage II of Fontaine's classification, with ankle/brachial index ≤ 0.90 and one or more stenosis >50% in at least one leg artery, were enrolled in the study. According to the Trans-Atlantic Inter Society Consensus II recommendations, 264 (55.1%) underwent percutaneous lower extremity angioplasty (PTA group), while 215 (44.9%) were managed with conservative therapy (MT group). The incidence of major cardiovascular events (including cardiovascular death, myocardial infarction, ischemic stroke, coronary and carotid revascularizations) was prospectively analyzed by Kaplan-Meier curves. Crude and adjusted HRs (95% CI) of developing a cardiovascular event were calculated by Cox analysis. RESULTS: No baseline differences were observed among the groups, except for a lower maximum walking distance in the PTA group. During a median follow-up of 21 months (12.0-29.0), the incidence of cardiovascular events was markedly lower in PTA compared to MT patients (6.4% vs. 16.3%; p=0.003), and patients in the MT group showed a 4.1-fold increased cardiovascular risk compared to patients in the PTA group, after adjustment for potential confounders (95% CI 1.22-13.57, p=0.023). CONCLUSIONS: This study shows that successful revascularization of LE-PAD patients affected by intermittent claudication, in addition to improving functional status, reduces the occurrence of future major cardiovascular events.
Keywords:	Peripheral Arterial Disease, Intermittent Claudication, Angioplasty, Prognosis
Source:	International Journal of Cardiology
ISSN:	0167-5273
Publisher:	Elsevier
Volume:	167
Number:	6
Page Range:	2566-2571
Date:	10 September 2013
Official Publication:	https://doi.org/10.1016/j.ijcard.2012.06.055
PubMed:	View item in PubMed

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