Document Detail


Predictors of mortality in patients with lower extremity peripheral arterial disease: 5-year follow-up.
MedLine Citation:
PMID:  19780889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Peripheral arterial disease (PAD) is associated with increased mortality. Lower extremity (LE) revascularization improves symptoms, but less is known about long-term survival benefits of LE arterial revascularization.
METHODS: Two hundred and eighty-three patients with an ankle brachial index (ABI) <or=0.9 were identified at the Veterans Administration Hospital, Danville, Illinois, and rates of LE arterial revascularization and all-cause mortality were measured at 5 years.
RESULTS: Of 283 patients identified, 42 (15%) underwent LE revascularization including 39 surgical procedures and 18 percutaneous interventions for symptomatic PAD. Eleven (26%) patients underwent repeat procedures over the 5 years of follow-up. Those undergoing revascularization were more often Caucasian (95% vs. 79%, P = 0.01) and had lower ABIs (ABI <or= 0.4, 45% vs. 17%, P = <0.001). At 44 +/- 19 months follow-up, there were fewer deaths in patients that underwent revascularization compared to patients who did not undergo revascularization; 10/42 (24%) versus 107/241 (44%) patients, P = 0.012. In a multivariate model LE arterial revascularization was associated with a trend toward lower all-cause mortality (HR 0.51 [95% CI 0.26-1.02], P = 0.056). Independent predictors of mortality were age >or=65 years (HR 2.42 [95% CI 1.52-3.85], P < 0.001), history of coronary artery disease (HR 1.67 [95% CI 1.13-2.46], P = 0.010), chronic kidney disease (HR 1.75 [95% CI 1.15-2.67], P = 0.010), and an ABI <or= 0.4 (HR 1.88 [95% CI 1.19-2.96], P = 0.006).
CONCLUSION: Few patients at this center with LE-PAD underwent arterial revascularization. After adjusting for baseline differences, there is a trend toward lower 5-year mortality in those undergoing LE arterial revascularization when compared to those who do not.
Authors:
Zehra Jaffery; Adam B Greenbaum; Mohammad F Siddiqui; Neetu Mahendraker; Vikesh Gupta; Vidu Mokkala; Uday Kanakadandi; Andrew Robbins; James McCord
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Publication Detail:
Type:  Journal Article     Date:  2009-09-25
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  22     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-22     Completed Date:  2011-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  564-70     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Ochsner Medical Center, New Orleans, Louisiana, USA. zjaffery@ochsner.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Ankle Brachial Index
Confidence Intervals
Female
Humans
Kaplan-Meier Estimate
Leg / blood supply*,  physiopathology
Male
Middle Aged
Multivariate Analysis
Peripheral Arterial Disease / mortality*,  surgery,  therapy
Proportional Hazards Models
Retrospective Studies
Risk Factors
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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