Journal of vascular surgery · 2025
Influence of heart failure on the clinical outcomes of patients with chronic limb-threatening ischemia after infrainguinal revascularization.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание 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.
Inoue Kentaro, Morisaki Koichi, Matsuda Daisuke, Guntani Atsushi, Ueno Kohei, Fujioka Yusuke, Kinoshita Go, Yoshino Shinichiro, Kurose Shun, Nakayama Ken, Yamaoka Terutoshi, Mii Shinsuke, Yoshizumi Tomoharu
Аннотация
OBJECTIVE: We examined the influence of heart failure (HF) on patients with chronic limb-threatening ischemia (CLTI) and the negative predictors of limb and life prognosis among patients with CLTI and HF, the clinical outcomes of patients with CLTI after infrainguinal revascularization were compared.
METHODS: Multicenter data of patients who underwent infrainguinal revascularization for CLTI between 2015 and 2022 were analyzed retrospectively. The end point was amputation-free survival (AFS) among patients with HF or without HF. Subgroup analyses among patients with HF were performed grouped by revascularization procedures or ejection fraction (EF) classification: HF with reduced EF (HFrEF) (EF of <40%), HF with mildly reduced EF (HFmrEF) (40% ≤ EF < 50%), and HF with preserved EF (HFpEF) (EF ≥50%).
RESULTS: Of the 772 patients included, 186 (24%) had HF. No differences were found in the Wound, Ischemia, foot Infection (WIfI) stage, Global Limb Anatomic Staging System stage, or treatment procedures between the HF and non-HF groups. The 2-year AFS rates of the HF and non-HF groups were 63% ± 2% vs 50% ± 4%, respectively (P < .01). Among the HF group, the AFS of the bypass group was significantly higher than that of the endovascular therapy (EVT) group (59% ± 7% vs 46% ± 5%; P = .04). Then, the AFS rates of the HFpEF, HFmrEF, and HFrEF groups were 61% ± 6%, 50% ± 8%, and 35% ± 7%, respectively (P < .01). Multivariate Cox proportional hazard analyses identified age ≥80 years, nonambulatory status, hypoalbuminemia (<3.5 g/dL), end-stage renal disease, EVT, WIfI stage 4, and HF as negative predictors of AFS among all patients. In the HF group, age ≥80 years, nonambulatory status, EVT, WIfI stage 4, and reduced EF (<40%) were significant negative predictors.
CONCLUSIONS: HF is a robust negative predictor of AFS among patients with CLTI who underwent infrainguinal revascularization. HFrEF was a negative predictor of AFS.
METHODS: Multicenter data of patients who underwent infrainguinal revascularization for CLTI between 2015 and 2022 were analyzed retrospectively. The end point was amputation-free survival (AFS) among patients with HF or without HF. Subgroup analyses among patients with HF were performed grouped by revascularization procedures or ejection fraction (EF) classification: HF with reduced EF (HFrEF) (EF of <40%), HF with mildly reduced EF (HFmrEF) (40% ≤ EF < 50%), and HF with preserved EF (HFpEF) (EF ≥50%).
RESULTS: Of the 772 patients included, 186 (24%) had HF. No differences were found in the Wound, Ischemia, foot Infection (WIfI) stage, Global Limb Anatomic Staging System stage, or treatment procedures between the HF and non-HF groups. The 2-year AFS rates of the HF and non-HF groups were 63% ± 2% vs 50% ± 4%, respectively (P < .01). Among the HF group, the AFS of the bypass group was significantly higher than that of the endovascular therapy (EVT) group (59% ± 7% vs 46% ± 5%; P = .04). Then, the AFS rates of the HFpEF, HFmrEF, and HFrEF groups were 61% ± 6%, 50% ± 8%, and 35% ± 7%, respectively (P < .01). Multivariate Cox proportional hazard analyses identified age ≥80 years, nonambulatory status, hypoalbuminemia (<3.5 g/dL), end-stage renal disease, EVT, WIfI stage 4, and HF as negative predictors of AFS among all patients. In the HF group, age ≥80 years, nonambulatory status, EVT, WIfI stage 4, and reduced EF (<40%) were significant negative predictors.
CONCLUSIONS: HF is a robust negative predictor of AFS among patients with CLTI who underwent infrainguinal revascularization. HFrEF was a negative predictor of AFS.
Предметные рубрики MeSH
AgedAged, 80 and overFemaleHumansMaleMiddle AgedAmputation, SurgicalChronic DiseaseChronic Limb-Threatening IschemiaEndovascular ProceduresHeart FailureIschemiaLimb SalvagePeripheral Arterial DiseaseProgression-Free SurvivalRetrospective StudiesRisk AssessmentRisk FactorsStroke VolumeTime FactorsTreatment Outcome