Cardiovascular and Limb Events Following Endovascular Revascularization Among Patients ≥65 Years Old: An American College of Cardiology PVI Registry Analysis.
Cardiovascular and Limb Events Following Endovascular Revascularization Among Patients ≥65 Years Old: An American College of Cardiology PVI Registry Analysis.
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DOI：
10.1161/jaha.121.024279
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发表时间：
2022-06-20
影响因子：
5.4
通讯作者：
Swaminathan, Rajesh, V
中科院分区：
文献类型：
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作者：
Weissler, E. Hope;Wang, Yongfei;Gales, Jordan M.;Feldman, Dmitriy N.;Arya, Shipra;Secemsky, Eric A.;Aronow, Herbert D.;Hawkins, Beau M.;Gutierrez, J. Antonio;Patel, Manesh R.;Curtis, Jeptha P.;Jones, W. Schuyler;Swaminathan, Rajesh, V
关键词：
我们旨在描述接受外周血管介入治疗（PVI）的外周动脉疾病（PAD）患者中主要不良心血管和肢体事件（MACE和MALE）的发生率，以及慢性肢体威胁性缺血（CLTI）患者中的相关因素。纳入了美国心脏病学会（ACC）国家心血管数据登记处的肺静脉隔离登记处接受肺静脉隔离的患者，这些患者可能与医疗保险和医疗补助服务中心的数据有关。主要结局为首次CLTI‐PVI或非CLTI‐PVI术后1个月和1年内的MACE、男性和再入院。使用考克斯比例风险回归确定与CLTI‐PVI患者主要结局发展相关的因素。有1758例（49.7%）患者接受了CLTI-PVI，1779例（50.3%）患者接受了非CLTI-PVI。1年时，29.5%的CLTI患者（n=519）发生MACE，34.0%的CLTI患者（n=598）发生MALE。1年时，8.2%的非CLTI患者（n=146）发生MACE，26.1%的非CLTI患者（n=465）发生MALE。CLTI-PVI中1年时MACE的预测因素包括接受血液透析的终末期肾病、充血性心力衰竭、既往CABG和重度肺病。CLTI-PVI中1年时男性的预测因素包括既往旁路移植术治疗、股深动脉治疗、终末期肾病血液透析和既往治疗病变的治疗。接受PVI的≥65岁患者的MACE和MALE发生率较高。一系列可修改和不可修改的患者因素、手术特征和药物与CLTI-PVI后MACE和MALE的发生相关。
We aimed to characterize the occurrence of major adverse cardiovascular and limb events (MACE and MALE) among patients with peripheral artery disease (PAD) undergoing peripheral vascular intervention (PVI), as well as associated factors in patients with chronic limb threatening ischemia (CLTI). Patients undergoing PVI in the American College of Cardiology’s (ACC) National Cardiovascular Data Registry’s PVI Registry who could be linked to Centers for Medicare and Medicaid Services data were included. The primary outcomes were MACE, MALE, and readmission within 1 month and 1 year following index CLTI‐PVI or non‐CLTI‐PVI. Cox proportional hazards regression was used to identify factors associated with the development of the primary outcomes among patients undergoing CLTI‐PVI. There were 1758 (49.7%) patients undergoing CLTI‐PVI and 1779 (50.3%) undergoing non‐CLTI‐PVI. By 1 year, MACE occurred in 29.5% of patients with CLTI (n=519), and MALE occurred in 34.0% of patients with CLTI (n=598). By 1 year, MACE occurred in 8.2% of patients with non‐CLTI (n=146), and MALE occurred in 26.1% of patients with non‐CLTI (n=465). Predictors of MACE at 1 year in CLTI‐PVI included end‐stage renal disease on hemodialysis, congestive heart failure, prior CABG, and severe lung disease. Predictors of MALE at 1 year in CLTI‐PVI included treatment of a prior bypass graft, profunda femoral artery treatment, end‐stage renal disease on hemodialysis, and treatment of a previously treated lesion. Patients ≥65 years old undergoing PVI experience high rates of MACE and MALE. A range of modifiable and non‐modifiable patient factors, procedural characteristics, and medications are associated with the occurrence of MACE and MALE following CLTI‐PVI.