Author + information
- Houman Khalili1,
- Haekyung Jeon-Slaughter2,
- Ehrin Armstrong3,
- Nicolas W. Shammas4,
- Khusrow Niazi5,
- Scott Kinlay6,
- Mazen Abu-Fadel7,
- Anand Prasad8,
- Bala Ramanan1 and
- Emmanouil Brilakis9
- 1University of Texas Southwestern Medical Center; VA North Texas Health Care System, Dallas, Texas, United States
- 2University of Texas Southwestern Medical Center, Dallas, Texas, United States
- 3University of Colorado, Denver, Colorado, United States
- 4Midwest Cardiovascular Research Foundation, Davenport, Iowa, United States
- 5Emory University, Atlanta, Georgia, United States
- 6VA Boston Healthcare System; Brigham and Women's Hospital, Boston, Massachusetts, United States
- 7University of Oklahoma HSC, Oklahoma City, Oklahoma, United States
- 8UT Health San Antonio, San Antonio, Texas, United States
- 9Minneapolis Heart Institute, UT Southwestern Medical Center/VA North Texas Health Care System, Minneapolis, Minnesota, United States
Chronic kidney disease (CKD) portends poor outcomes in patients with peripheral artery disease, however outcomes following lower extremity peripheral artery interventions (LE-PAI) have not been well characterized.
Data from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry was analyzed. Patient outcomes including all-cause mortality, myocardial infarction (MI), target limb major amputation, and clinically driven repeat target limb revascularization (CD-TLR) at 12 months were analyzed. Kaplan-Meier (KM) time to event analysis was performed.
Data from 2,996 infra-inguinal LE-PAIs from 2,105 patients between May 2005 and June 2017 were included; 12 months data was available for 1,748 patients. CKD was present in 18% (n=378) of the cohort. CKD group had higher rates of comorbidities and more severe PAD presentation (Table). CKD was associated with a higher mortality (5.5% vs 2.0%; p=0.0002) and KM analysis showed significant association with mortality in the 12 months post LE-PAI period (log chi square = 32.12; p<0.0001; Figure). Rates of MI (2.7% vs 1.5%; p=0.05) and major limb amputation (3.8% vs 1.3%; p<0.0001) were also higher in the CKD group; there was no different in the stroke or CD-TLR rates.
|Patients (n)||CKD (n=378)||Non CKD (n=1727)||P-value|
|Age (mean±SD)||66.8±10.3 years||65.9±10.1 years||0.1113|
|Female (n, %)||81 (21.3%)||380 (22.0%)||0.6894|
|Hypertension (n, %)||367 (96.6%)||1526 (88.5%)||<0.0001|
|Diabetes mellitus (n, %)||298 (78.4%)||873 (50.6%)||<0.0001|
|Coronary artery disease (n, %)||279 (73.4%)||1038 (60.2%)||<0.0001|
|Heart failure (n, %)||126 (33.2%)||246 (14.3%)||<0.0001|
|Ankle-brachial index (mean±SD)||0.75±0.21||0.73±0.25||0.2082|
Patients with CKD following LE-PAI have significantly higher mortality and major limb amputation at 12 months.
ENDOVASCULAR: Peripheral Vascular Disease and Intervention