Abstract 3227: Long-Term Mortality of Patients with Peripheral Arterial Disease Undergoing Elective Peripheral Intervention
Background: A little is known about long-term outcomes of patients with PAD undergoing peripheral intervention (PI). In this study, we tried to evaluate its impact on survival.
Methods: This is the study of 679 consecutive patients (pts) with PAD that were treated by PI. We examined long-term clinical outcomes of pts received PI in our hospital from Jan.1990 to Dec.2003.
Results: This study population comprised of 679 pts with a mean age of 69±7 years, 82% of male gender, 51% with coronary artery disease (CAD), 33% with diabetes mellitus (DM), 14% with renal insufficiency (RI; Cre>1.5mg/dl), 39% with smoking, 19% with cerebrovascular accident (CVA) 62% with any vascular reconstruction including bypass surgery and vascular intervention and 38% with history of myocardial infarction (MI). A total of 918 endovascular procedures were performed and their 98% (stent 53%) were considered to be technically and clinically successful. All patients were discharged alive and constituted the study population for long-term outcomes. Clinical follow-up information was obtained in 627 (93%) patients at a mean follow-up time of 7.2±3.1 years. During the follow-up period, 255 (38%) pts died (sudden death 9%, cardiac death 41%, malignancy 16%, cerebrovascular disease 9% and others 25%). Death occurred by any vascular event was 64%. Kaplan-Meyer curve showed that freedom from death was 72% (5 years), 61% (8 years), and 55% (10 years) and vascular-event free survival rate from death / MI / any vascular reconstruction / CVA / major and minor amputation was 36% (5 years), 24% (8 years), and 19% (10 years). Using multivariate Cox regression, age (Hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.01 to 1.07, p=0.003), CAD (HR 4.4, 95% CI 3.5 to 6.8, p=0.002), DM (HR 2.4, 95% CI 1.5 to 3.8, p=0.002) and RI (HR 3.7, 95% CI 2.1 to 5.7, p=0.01) were identified as predictors in overall survival.
Conclusions: Regardless of successful PI, the survival of pts with PAD was poor. Age, CAD, DM, and RI were identified as independent predictors of late mortality.