Mislav Vrsalovic1,2, Ksenija Vucur3, Ana Vrsalovic Presecki4, Damir Fabijanic5, Milan Milosevic1,6. 1. University of Zagreb, School of Medicine, Zagreb, Croatia. 2. Department of Vascular Medicine, Cardiovascular Center, Sisters of Charity University Hospital Center, Zagreb, Croatia. 3. Department of Nephrology, University Hospital Merkur, Zagreb, Croatia. 4. Faculty of Chemical Engineering and Technology, University of Zagreb, Zagreb, Croatia. 5. Department of Cardiology, University Hospital Centre Split, School of Medicine, University of Split, Split, Croatia. 6. Andrija Stampar School of Public Health, Zagreb, Croatia.
Abstract
BACKGROUND: There are accumulating studies showing the association between diabetes and all-cause mortality in peripheral vascular disease. However, the results in these studies are conflicting regarding the impact of diabetes on outcome. HYPOTHESIS: Diabetes is associated with increased risk of mortality in peripheral artery disease. METHODS: Using MEDLINE and Scopus, we searched for studies published before January 2016. Additionally, studies were identified by manual search of references of original articles or review studies on this topic. Of the 1072 initially identified records, 21 studies with 15,857 patients were included in the final analysis. RESULTS: Diabetes was associated with a statistically significant increased risk of all-cause mortality (odds ratio: 1.89, 95% confidence interval: 1.51-2.35, P < 0.001), without detected publication bias (Egger bias = 0.75, P = 0.631). The stronger effect on outcome was obtained in patients with critical limb ischemia (odds ratio: 2.38, 95% confidence interval: 1.22-4.63, P < 0.001) as the most severe form of peripheral vascular disease. CONCLUSIONS: Diabetes is associated with an increased risk of mortality in peripheral vascular disease, and the effect is even more pronounced in patients with critical limb ischemia.
BACKGROUND: There are accumulating studies showing the association between diabetes and all-cause mortality in peripheral vascular disease. However, the results in these studies are conflicting regarding the impact of diabetes on outcome. HYPOTHESIS: Diabetes is associated with increased risk of mortality in peripheral artery disease. METHODS: Using MEDLINE and Scopus, we searched for studies published before January 2016. Additionally, studies were identified by manual search of references of original articles or review studies on this topic. Of the 1072 initially identified records, 21 studies with 15,857 patients were included in the final analysis. RESULTS:Diabetes was associated with a statistically significant increased risk of all-cause mortality (odds ratio: 1.89, 95% confidence interval: 1.51-2.35, P < 0.001), without detected publication bias (Egger bias = 0.75, P = 0.631). The stronger effect on outcome was obtained in patients with critical limb ischemia (odds ratio: 2.38, 95% confidence interval: 1.22-4.63, P < 0.001) as the most severe form of peripheral vascular disease. CONCLUSIONS:Diabetes is associated with an increased risk of mortality in peripheral vascular disease, and the effect is even more pronounced in patients with critical limb ischemia.
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