Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention.

<h4>Background</h4>Patients with peripheral arterial disease (PAD) have known to a high risk of cardiac mortality. However, the effectiveness of the routine evaluation of coronary arteries such as routine coronary angiography (CAG) in PAD patients receiving percutaneous transluminal angi...

Full description

Bibliographic Details
Main Authors: Byoung Geol Choi, Ji-Yeon Hong, Seung-Woon Rha, Cheol Ung Choi, Michael S Lee
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0251542
id doaj-de1bd3f278314132b9b8a8cef64843f2
record_format Article
spelling doaj-de1bd3f278314132b9b8a8cef64843f22021-05-30T04:30:17ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01165e025154210.1371/journal.pone.0251542Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention.Byoung Geol ChoiJi-Yeon HongSeung-Woon RhaCheol Ung ChoiMichael S Lee<h4>Background</h4>Patients with peripheral arterial disease (PAD) have known to a high risk of cardiac mortality. However, the effectiveness of the routine evaluation of coronary arteries such as routine coronary angiography (CAG) in PAD patients receiving percutaneous transluminal angioplasty (PTA) is unclear.<h4>Methods</h4>A total of 765 consecutive PAD patients underwent successful PTA and 674 patients (88.1%) underwent routine CAG. Coronary artery disease (CAD) was defined as angiographic stenosis ≥70%. Patients were divided into three groups; 1) routine CAG and a presence of CAD (n = 413 patients), 2) routine CAG and no CAD group (n = 261 patients), and 3) no CAG group (n = 91 patients). To adjust for any potential confounders that could cause bias, multivariable Cox-proportional hazards regression and propensity score matching (PSM) analysis was performed. Clinical outcomes were evaluated by Kaplan-Meier curved analysis at 5-year follow-up.<h4>Results</h4>In this study, the 5-year survival rate of patients with PAD who underwent PTA was 88.5%. Survival rates were similar among the CAD group, the no CAD group, and the no CAG group, respectively (87.7% vs. 90.4% vs. 86.8% P = 0.241). After PSM analysis between the CAD group and the no CAD group, during the 5-year clinical follow-up, there were no differences in the incidence of death, myocardial infarction, strokes, peripheral revascularization, or target extremity surgeries between the two groups except for repeat PCI, which was higher in the CAD group than the non-CAD group (9.3% vs. 0.8%, P<0.001).<h4>Conclusion</h4>PAD patients with CAD were expected to have very poor long-term survival, but they are shown no different long-term prognosis such as mortality compared to PAD patients without CAD. These PAD patients with CAD had received PCI and/or optimal medication treatment after the CAG. Therefore a strategy of routine CAG and subsequent PCI, if required, appears to be a reasonable strategy for mortality risk reduction of PAD patients. Our results highlight the importance for evaluation for CAD in patients with PAD.https://doi.org/10.1371/journal.pone.0251542
collection DOAJ
language English
format Article
sources DOAJ
author Byoung Geol Choi
Ji-Yeon Hong
Seung-Woon Rha
Cheol Ung Choi
Michael S Lee
spellingShingle Byoung Geol Choi
Ji-Yeon Hong
Seung-Woon Rha
Cheol Ung Choi
Michael S Lee
Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention.
PLoS ONE
author_facet Byoung Geol Choi
Ji-Yeon Hong
Seung-Woon Rha
Cheol Ung Choi
Michael S Lee
author_sort Byoung Geol Choi
title Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention.
title_short Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention.
title_full Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention.
title_fullStr Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention.
title_full_unstemmed Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention.
title_sort long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2021-01-01
description <h4>Background</h4>Patients with peripheral arterial disease (PAD) have known to a high risk of cardiac mortality. However, the effectiveness of the routine evaluation of coronary arteries such as routine coronary angiography (CAG) in PAD patients receiving percutaneous transluminal angioplasty (PTA) is unclear.<h4>Methods</h4>A total of 765 consecutive PAD patients underwent successful PTA and 674 patients (88.1%) underwent routine CAG. Coronary artery disease (CAD) was defined as angiographic stenosis ≥70%. Patients were divided into three groups; 1) routine CAG and a presence of CAD (n = 413 patients), 2) routine CAG and no CAD group (n = 261 patients), and 3) no CAG group (n = 91 patients). To adjust for any potential confounders that could cause bias, multivariable Cox-proportional hazards regression and propensity score matching (PSM) analysis was performed. Clinical outcomes were evaluated by Kaplan-Meier curved analysis at 5-year follow-up.<h4>Results</h4>In this study, the 5-year survival rate of patients with PAD who underwent PTA was 88.5%. Survival rates were similar among the CAD group, the no CAD group, and the no CAG group, respectively (87.7% vs. 90.4% vs. 86.8% P = 0.241). After PSM analysis between the CAD group and the no CAD group, during the 5-year clinical follow-up, there were no differences in the incidence of death, myocardial infarction, strokes, peripheral revascularization, or target extremity surgeries between the two groups except for repeat PCI, which was higher in the CAD group than the non-CAD group (9.3% vs. 0.8%, P<0.001).<h4>Conclusion</h4>PAD patients with CAD were expected to have very poor long-term survival, but they are shown no different long-term prognosis such as mortality compared to PAD patients without CAD. These PAD patients with CAD had received PCI and/or optimal medication treatment after the CAG. Therefore a strategy of routine CAG and subsequent PCI, if required, appears to be a reasonable strategy for mortality risk reduction of PAD patients. Our results highlight the importance for evaluation for CAD in patients with PAD.
url https://doi.org/10.1371/journal.pone.0251542
work_keys_str_mv AT byounggeolchoi longtermoutcomesofperipheralarterialdiseasepatientswithsignificantcoronaryarterydiseaseundergoingpercutaneouscoronaryintervention
AT jiyeonhong longtermoutcomesofperipheralarterialdiseasepatientswithsignificantcoronaryarterydiseaseundergoingpercutaneouscoronaryintervention
AT seungwoonrha longtermoutcomesofperipheralarterialdiseasepatientswithsignificantcoronaryarterydiseaseundergoingpercutaneouscoronaryintervention
AT cheolungchoi longtermoutcomesofperipheralarterialdiseasepatientswithsignificantcoronaryarterydiseaseundergoingpercutaneouscoronaryintervention
AT michaelslee longtermoutcomesofperipheralarterialdiseasepatientswithsignificantcoronaryarterydiseaseundergoingpercutaneouscoronaryintervention
_version_ 1721421253011570688