Annals of medicine · 2025
Prevalence of extracranial carotid artery disease in symptomatic peripheral artery disease and implications for long-term outcome.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zierfuss Bernhard, Witt-Dörring Ladislaja, Ceschi A Santa Croce Anna, Hannes Antonia, Staudacher Moritz, Pesau Gerfried, Schlager Oliver, Gschwandtner Michael, Schernthaner Gerit-Holger, Höbaus Clemens
Аннотация
BACKGROUND: Patients with peripheral artery disease (PAD) still experience excessive rates of fatal cardiovascular events. In this context, the relevance of co-existing extracranial carotid artery disease (ECAD) on outcome in patients with PAD is unclear. Thus, this study elucidates long-term outcome effects of the presence of both atherosclerotic entities for further risk stratification.
MATERIALS AND METHODS: A total of 669 patients from the Lip-LEAD study with symptomatic PAD (Fontaine stage 2-4) were evaluated for ECAD (internal carotid artery stenosis >50%) with ultrasonography within 6 months after endovascular repair for PAD. Outcome was assessed with a long-term follow-up period with a maximum of 10 years.
RESULTS: Patients presenting with ECAD (n = 245, 36.7%) exhibited worse hemodynamic parameters of PAD than those without (ankle-brachial index (ABI). (0.53 (0.37-0.68) vs. 0.57 (0.47-0.68), p = 0.009; toe-brachial index (TBI) (0.50 (0.36-0.63) vs. 0.55 (0.42-0.70), p = 0.005). Significant correlations between grade of carotid stenosis and ABI as well as TBI were present (r=-0.190, p < 0.001; r=-0.219, p < 0.001). Cox-regression analyses revealed worse outcome in patients with ECAD for both all-cause and cardiovascular (CV)-mortality after multivariable adjustment for traditional CV risk-factors [1.48 (2.02-2.17); 2.10 (1.19-3.69)].
CONCLUSION: Patients with additional ECAD to symptomatic PAD exhibited an unfavourable long-term outcome in comparison to those without. The results suggest that the additional presence of ECAD highlights a highly vulnerable cohort of patients with symptomatic PAD at risk for further fatal CV events and thus should be considered for further diagnostic evaluation and stronger risk modification initiatives.
MATERIALS AND METHODS: A total of 669 patients from the Lip-LEAD study with symptomatic PAD (Fontaine stage 2-4) were evaluated for ECAD (internal carotid artery stenosis >50%) with ultrasonography within 6 months after endovascular repair for PAD. Outcome was assessed with a long-term follow-up period with a maximum of 10 years.
RESULTS: Patients presenting with ECAD (n = 245, 36.7%) exhibited worse hemodynamic parameters of PAD than those without (ankle-brachial index (ABI). (0.53 (0.37-0.68) vs. 0.57 (0.47-0.68), p = 0.009; toe-brachial index (TBI) (0.50 (0.36-0.63) vs. 0.55 (0.42-0.70), p = 0.005). Significant correlations between grade of carotid stenosis and ABI as well as TBI were present (r=-0.190, p < 0.001; r=-0.219, p < 0.001). Cox-regression analyses revealed worse outcome in patients with ECAD for both all-cause and cardiovascular (CV)-mortality after multivariable adjustment for traditional CV risk-factors [1.48 (2.02-2.17); 2.10 (1.19-3.69)].
CONCLUSION: Patients with additional ECAD to symptomatic PAD exhibited an unfavourable long-term outcome in comparison to those without. The results suggest that the additional presence of ECAD highlights a highly vulnerable cohort of patients with symptomatic PAD at risk for further fatal CV events and thus should be considered for further diagnostic evaluation and stronger risk modification initiatives.