Osamu Iida1, Mitsuyoshi Takahara2, Yoshimitsu Soga3, Nobuyoshi Azuma4, Shinsuke Nanto5, Masaaki Uematsu6. 1. Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan. Electronic address: iida.osa@gmail.com. 2. Department of Diabetes Care Medicine, and Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan. 3. Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. 4. Department of Vascular Surgery, Asahikawa Medical University, Asahikawa, Japan. 5. Department of Cardiology, Nishinomiya Municipal Central Hospital, Nishinomiya, Japan. 6. Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan.
Abstract
OBJECTIVES: The authors sought to investigate the prognostic impact of revascularization for poor-risk CLI patients in real-world settings. BACKGROUND: Critical limb ischemia (CLI) is often accompanied with various comorbidities, and frailty is not rare in the population. Although previous studies suggested favorable outcomes of revascularization for CLI patients, those studies commonly included the healthier, that is, less frail patients. METHODS: This was a multicenter prospective observational study, registering patients who presented with CLI and who required assistance for their daily lives because of their disability in activities of daily living (ADL) and/or impairment of cognitive function. Revascularization was either planned (revascularization group) or not planned (non-revascularization group). The primary endpoint was 1-year survival, and was compared between the revascularization and non-revascularization groups, using the propensity score-matching method. RESULTS: Between January 2014 and April 2015, a total of 662 patients were registered, of those 100 non-revascularization patients were included. A total of 625 patients (94.4%) completed the 1-year follow-up. Death was observed in 223 patients (33.7%). After propensity score matching, the 1-year survival rate was 55.9% in the revascularization group versus 51.0% in the non-revascularization group, with no significant difference (p = 0.120). In the subgroups alive at 1 year after revascularization, health-related quality of life was significantly improved compared with baseline, whereas ADL scores were unchanged from baseline and still remained significantly worse than before CLI onset. CONCLUSIONS: The 1-year overall survival rate was not significantly different between the revascularization and non-revascularization groups in poor-risk CLI patients. (Poor-Risk Patients With and Without Revascularization Therapy for Critical Limb Ischemia; [PRIORITY Registry]; UMIN000012871).
OBJECTIVES: The authors sought to investigate the prognostic impact of revascularization for poor-risk CLI patients in real-world settings. BACKGROUND:Critical limb ischemia (CLI) is often accompanied with various comorbidities, and frailty is not rare in the population. Although previous studies suggested favorable outcomes of revascularization for CLI patients, those studies commonly included the healthier, that is, less frail patients. METHODS: This was a multicenter prospective observational study, registering patients who presented with CLI and who required assistance for their daily lives because of their disability in activities of daily living (ADL) and/or impairment of cognitive function. Revascularization was either planned (revascularization group) or not planned (non-revascularization group). The primary endpoint was 1-year survival, and was compared between the revascularization and non-revascularization groups, using the propensity score-matching method. RESULTS: Between January 2014 and April 2015, a total of 662 patients were registered, of those 100 non-revascularization patients were included. A total of 625 patients (94.4%) completed the 1-year follow-up. Death was observed in 223 patients (33.7%). After propensity score matching, the 1-year survival rate was 55.9% in the revascularization group versus 51.0% in the non-revascularization group, with no significant difference (p = 0.120). In the subgroups alive at 1 year after revascularization, health-related quality of life was significantly improved compared with baseline, whereas ADL scores were unchanged from baseline and still remained significantly worse than before CLI onset. CONCLUSIONS: The 1-year overall survival rate was not significantly different between the revascularization and non-revascularization groups in poor-risk CLI patients. (Poor-Risk Patients With and Without Revascularization Therapy for Critical Limb Ischemia; [PRIORITY Registry]; UMIN000012871).
Authors: Francisco Ujueta; Ivan A Arenas; Esteban Escolar; Denisse Diaz; Robin Boineau; Daniel B Mark; Patrick Golden; Lauren Lindblad; Hwasoon Kim; Kerry L Lee; Gervasio A Lamas Journal: J Diabetes Complications Date: 2019-04-14 Impact factor: 2.852
Authors: Jihad A Mustapha; Zsuzsanna Igyarto; David O'Connor; Ehrin J Armstrong; Anthony R Iorio; Vickie R Driver; Fadi Saab; Ann N Behrens; Brad J Martinsen; George L Adams Journal: Vasc Health Risk Manag Date: 2020-02-10
Authors: Stijn L Steunenberg; Jolanda de Vries; Jelle W Raats; Nathalie Verbogt; Paul Lodder; Geert-Jan van Eijck; Eelco J Veen; Hans Gw de Groot; Gwan H Ho; Lijckle van der Laan Journal: Clin Interv Aging Date: 2019-07-08 Impact factor: 4.458