Abstract 18294: Long-Term Outcomes of Diabetic Patients Undergoing Percutaneous Intervention for Popliteal and Infrapopliteal Peripheral Arterial Disease-Insights From the Laser in Infra-Popliteal & Popliteal Stenosis (LIPS) Study
Introduction: Patients (pts) with diabetes mellitus (DM) are more likely to have popliteal and infrapopliteal peripheral arterial disease (PAD). Clinical features and outcomes of these pts are less well known.
Methods: We evaluated the data of the LIPS study to examine the clinical features and adjusted long-term outcomes of pts with and without DM undergoing popliteal and infrapopliteal peripheral vascular interventions (PVI).
Results: Of 714 pts in the study, 418 had DM (59%). Compared to the pts without DM, those with DM despite being younger (73±11.3 vs. 70±11.2 yrs) had higher comorbidities - CAD (62 vs. 76%), CHF (22 vs. 30%), ESRD (3 vs. 17%), and prior contralateral limb amputation (2 vs. 15%). All cause mortality (36 vs. 26%; [OR=1.61, 95% CI 1.13-2.29]) and major adverse vascular events (composite of death, major amputation and repeat revascularization; (54 vs. 40%; [OR=1.97, 95% CI 1.44-2.69]) were higher in DM pts (mean follow up 36±20 months, Figure 1). Major amputation rate in the ipsilateral limb was also higher in DM pts (6.7 vs. 1.4%; OR=6.6 [95% CI 2.01-19.83] Figure 2). Compared with DM pts with HbA1C at goal, those with HbA1C not at goal had higher revascularization rate (34 vs. 21%) but not death or major amputations.
Conclusions: The prevalence of DM in pts with popliteal and infrapopliteal PAD was quite high and was associated with higher death, major amputations and MAVE following PVI that was independent of baseline comorbidities. At goal HbA1C was associated with lower subsequent revascularization. Our data suggest the need for novel medical and interventional therapies to improve long-term outcomes in these high-risk pts with popliteal and infrapopliteal PAD with DM.
Author Disclosures: S. Neupane: None. S. Edla: None. E. Maidona: None. S.M. Szpunar: None. T.A. Lalonde: None. R.H. Mehta: None. H.S. Rosman: None. H. Yamasaki: None.
- © 2016 by American Heart Association, Inc.