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

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Item Type:	Article
Title:	Effects of successful percutaneous lower extremity revascularization on cardiovascular outcome in patients with peripheral arterial disease
Creators Name:	Giugliano, G., Di Serafino, L., Perrino, C., Schiano, V., Laurenzano, E., Cassese, S., De Laurentis, M., Schiattarella, G.G., Brevetti, L., Sannino, A., Gargiulo, G., Franzone, A., Indolfi, C., Piscione, F., 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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