Predictors of mortality in patients with lower extremity peripheral arterial disease: 5-year follow-up

Zehra Jaffery, Adam B. Greenbaum, Mohammad F. Siddiqui, Neetu Mahendraker, Vikesh Gupta, Vidu Mokkala, Uday Kanakadandi, Andrew Robbins, James McCord

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

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) ≤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 ≤ 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 ≥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 ≤ 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.

Original languageEnglish (US)
Pages (from-to)564-570
Number of pages7
JournalJournal of Interventional Cardiology
Volume22
Issue number6
DOIs
StatePublished - Dec 1 2009

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Jaffery, Z., Greenbaum, A. B., Siddiqui, M. F., Mahendraker, N., Gupta, V., Mokkala, V., Kanakadandi, U., Robbins, A., & McCord, J. (2009). Predictors of mortality in patients with lower extremity peripheral arterial disease: 5-year follow-up. Journal of Interventional Cardiology, 22(6), 564-570. https://doi.org/10.1111/j.1540-8183.2009.00505.x