Author + information
- S1936879815021457-700cf5cb00fe36da60d3e624b1bc5958Ji Young Park1,
- S1936879815021457-83e45353357d710a9dde9c5071cfa225Seung-Woon Rha2,
- S1936879815021457-38f9379288aee4a50a9131fa84c4a249Byoung Geol Choi2,
- S1936879815021457-5ad2c1999ed23ad295759ce26e3acbe8Se Yeon Choi2,
- S1936879815021457-53b75c6df57ff3836114113292e7ed5aSang-Ho Park3 and
- S1936879815021457-e7fb692d66d88666def902b2ab5ef87fJi Yeon Hong4
Peripheral arterial disease (PAD) is known to be associated with poor outcomes and cardiac valve sclerosis (CVS) is reported to be associated with future cardiovascular events. We evaluated the association of CVS with the clinical outcomes in patients (pts) with PAD who underwent percutaneous transluminal angioplasty (PTA).
The outcomes of 298 consecutive pts with symptomatic PAD who underwent PTA were enrolled for analysis. Study populations were divided into two groups; PAD with CVS (n=41) and PAD without CVS (n=257). CVS (Aortic or mitral valve sclerosis) is defined as calcification and thickening of leaflets in aortic or mitral valve in the absence of obstruction of ventricular outflow. The incidence of restenosis, amputation rates and clinical outcomes were assessed at a follow-up of 2 years.
Pts with CVS had higher incidence of wounds as the initial diagnosis for PAD (80.5% vs. 56.0%, p=0.003), diabetes mellitus (92.7% vs.70.8%, p=0.002), hypertension (87.8% vs. 67.3%, p=0.009), chronic kidney disease (43.9% vs. 23.0 %, p=0.007), need for dialysis (34.1% vs. 16.0%, p=0.009), and previous history of percutaneous coronary intervention (26.8% vs. 13.6%, P=0.037). At 8 months follow-up, patients with CVS had higher rate of total occlusion of the limb (83.3% vs. 33.6%, p=0.023). At 2-year follow up, the incidence of repeat PTA and major adverse cardiovascular events (MACE) was similar between the two groups, but the pts with CVS had higher amputation rate (39.3% vs. 15.6%, p=0.005).
In this study, patients with CVS had more frequently presented with critical limb ischemia, higher rates of total occlusion and amputation rate at 2 years following successful PTA compared with those of PAD without CVS. More intensive therapies will be needed for this particular subset of risky patients.