Cardiovascular Outcome and Mortality in Patients Undergoing Endovascular Treatment for Symptomatic Peripheral Artery Disease　- Short-Term Results of the Toma-Code Registry.

Abstract

BACKGROUND:

The present study was performed to clarify whether the preoperative clinical symptoms for endovascular therapy (EVT) can predict post-EVT death and cardiovascular prognosis in Japanese patients with peripheral artery disease (PAD), including acute disease.Methods and Results:The TOkyo taMA peripheral vascular intervention research COmraDE (Toma-Code) Registry is a Japanese prospective cohort of 2,321 consecutive patients with PAD treated with EVT, in 34 hospitals in the Kanto and Kōshin'etsu regions, from August 2014 to August 2016. In total, 2,173 symptomatic patients were followed up for a median of 10.4 months, including 1,370 with claudication, 719 with critical limb ischemia (CLI), and 84 with acute limb ischemia (ALI) for EVT. The all-cause death rates per 100 person-years for claudication, CLI and ALI were 3.5, 26.2, and 24.5, respectively. Similarly, major adverse cardiac and cerebrovascular events (MACCE) rates per 100 person-years for claudication, CLI, ALI, and others were 5.2, 31.2, and 29.7, respectively. After adjusting for the predictors of all-cause death and MACCE, namely, age, body mass index <18, diabetes mellitus, dialysis, cerebrovascular disease, and low left ventricular ejection fraction, it was determined that the preoperative indication for EVT was strongly associated with all-cause death and MACCE.

CONCLUSIONS:

The preoperative clinical symptoms for EVT can predict the prognosis in patients with PAD undergoing EVT.

• Authors: Michiaki Higashitani, Yukari Uemura, Atsushi Mizuno, Makoto Utsunomiya, Tetsuo Yamaguchi, Akihiro Matsui, Shunsuke Ozaki, Kazuki Tobita, Atsushi Tosaka, Akitsugu Oida, Kenji Suzuki, Takahide Kodama, Kentaro Jujo, Tatsuki Doijiri, Yasuhiro Takahashi, Shunsuke Matsuno, Nobuhito Kaneko, Akira Moriguchi, Shohei Kishi, Hitoshi Anzai, Toma-Code Registry Investigators
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 82 Issue 7 Pg. 1917-1925 (06 25 2018) ISSN: 1347-4820 [Electronic] Japan
• PMID: 29760308 (Publication Type: Journal Article)

Topics

• Aged
• Asian People
• Cardiovascular Diseases (mortality)
• Cohort Studies
• Endovascular Procedures (adverse effects, methods, mortality)
• Extremities (pathology)
• Female
• Humans
• Intermittent Claudication
• Ischemia
• Male
• Middle Aged
• Peripheral Arterial Disease (complications, therapy)
• Prognosis
• Registries
• Tokyo
• Treatment Outcome