Acta clinica Croatica, Vol. 55. No. 2., 2016.
Original scientific paper
https://doi.org/10.20471/acc.2016.55.02.09
Diabetes and critical limb ischemia: the deadly duo in patients with symptomatic peripheral artery disease
Mislav Vrsalović
; School of Medicine, University of Zagreb, Zagreb Croatia; Department of Vascular Medicine, Cardiovascular Center, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ksenija Vučur
; Institute of Emergency Medicine of the Zagreb County, Zagreb, Croatia
Abstract
Inflammation plays an important role in the initiation and progression of peripheral artery disease (PAD). Patients with diabetes have an increased risk of developing PAD. Data regarding the prognostic implication of diabetes and inflammation in PAD patients are scarce. The aim of the study was to investigate the impact of diabetes and inflammation on all-cause mortality in patients with symptomatic PAD and preserved left ventricular ejection fraction (LVEF >50%). The
study was conducted at the Sestre milosrdnice University Hospital Center between January 2010 and January 2014 on 319 consecutive patients with symptomatic PAD and preserved LVEF (66.5% men, mean age 70±10 years, ankle brachial index 0.58±0.14). Thirty-eight (12%) patients died during median follow up period of 24 months (interquartile range, 16-34 months). On univariate analysis, C-reactive protein was significantly associated with all-cause mortality (HR 2.21, 95% CI 1.09-4.48). After multivariate regression analysis, age (HR 1.07, 95% CI 1.02-1.11), diabetes (HR 2.24, 95% CI
1.04-4.82), and critical limb ischemia (HR 2.22, 95% CI 1.03-4.80) remained the only independent predictors for all-cause mortality. Diabetes and critical limb ischemia are independently associated
with an increased risk of mortality in symptomatic PAD patients with preserved LVEF.
Keywords
Diabetes mellitus; Extremities – blood supply; Ischemia; Infl ammation; C-reactive protein; Peripheral arterial disease
Hrčak ID:
164853
URI
Publication date:
1.6.2016.
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