Abstract 11536: Predictors of 2-Year Mortality And Risk Stratification After Endovascular Therapy for Patients With Critical Limb Ischemia
Objectives: The BASIL investigators reported that overall survival and amputation-free survival were not different at 2 years after randomization to angioplasty-first or bypass-first revascularization strategies. However, beyond 2 years there appeared to be a benefit for open bypass surgery. The objective of this study was to examine predictors of 2-year mortality and risk stratification after endovascular therapy (EVT) for patients with critical limb ischemia (CLI).
Methods: Between January 2007 and June 2011, 279 consecutive patients with CLI (Rutherford IV, V, VI) who underwent EVT were enrolled, and assigned to two groups; alive at > 2 years or dead within 2 years. Multivariate analysis was performed to explore independent mortality determinants and risk stratification.
Results: Notable overall baseline characteristics included patient age (72±11yrs), male gender (64%, 178/279), diabetes mellitus (67%, 186/279), and end stage renal disease (ESRD) on dialysis (51%, 141/279). Death occurred in 63 patients within 2 years. Non-ambulatory status, body mass index, CRP, Rutherford criteria, chronic heart failure (CHF), ESRD, hemoglobin and age were chosen as independent variables related to mortality by single regression analysis. Among these, CRP>5 mg/dl (hazard ratio [HR], 2.6; 95% confidence interval [CI], 1.11-6.26), CHF (HR, 2.82; 95% CI, 1.19-6.71) and non-ambulatory status (HR, 0.13; 95% CI, 0.06-0.29) were the strongest independent predictors of 2-year mortality by multivariate analysis. The figure shows stratification of patient survival by number of risk factors after multivariate analysis.
Conclusion: The predictors of mortality within 2 years after EVT for patients with CLI are CRP>5 mg/dl, CHF and non-ambulatory status. Risk stratification allows estimation of 2-year mortality in patients with CLI.
- © 2012 by American Heart Association, Inc.