| Predictors of mortality in patients with lower extremity peripheral arterial disease: 5-year follow-up. | |
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MedLine Citation:
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PMID: 19780889 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article Date: 2009-09-25 |
Journal Detail:
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Title: Journal of interventional cardiology Volume: 22 ISSN: 1540-8183 ISO Abbreviation: J Interv Cardiol Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-22 Completed Date: 2011-01-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8907826 Medline TA: J Interv Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 564-70 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Ochsner Medical Center, New Orleans, Louisiana, USA. zjaffery@ochsner.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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