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Peripheral arterial disease (PAD) is known to be associated with poor outcomes. However, the impact of smoking on major clinical outcomes following percutaneous transluminal angioplasty (PTA) is not clear yet.
The 559 consecutive symptomatic PAD patients (pts) who underwent PTA were enrolled for this analysis. The incidence of restenosis, amputation rate and repeat revascularization were assessed between the current smoker (n=177) and non-smokers (n=382) in significant PAD (pts) who underwent PTA at 1 year.
Current smokers had more male gender (96.0% vs. 69.4%, p<0.01), whereas non-smokers had a higher incidence of hypertension (63.3% vs. 72.8%, p=0.029), diabetes mellitus (68.4% vs. 76.7%; P=0.039), cerebral vascular disease (11.3% vs. 20.2%, p=0.011), chronic kidney disease (22.0% vs. 31.2%; p=0.027), need for dialysis (11.9% vs. 22.8%; p=0.003), coronary artery disease (48.0% vs. 59.2%, p=0.017). Wounds as the initial diagnosis were higher in non-smoker group (55.9% vs. 68.6%, p=0.004), but ischemic resting pain as the initial diagnosis was highr in current smoker group (21.5% vs. 9.7% p<0.01) . PTA at iliac artery (36.2% vs. 20.2%, p<0.01), femoral artery (21.5% vs. 13.1%, p=0.017), and below the knee (60.5% vs. 72.8%, p=0.004) was more commonly performed in the current smokers. At 8 months, non-smokers had higher rate of total occlusion of the limb (35.1% vs. 50.8%, p=0.039). At 1-year, the incidence of repeat PTA, amputation rate, and major adverse cardiovascular events (MACE) were similar between the two groups.
Although current smokers had lower incidence of traditional cardiovascular risks, more frequently presented with critical limb ischemia and had higher rates of PTA compared with symptomatic PAD with non-smokers. Despite of expected worse outcomes in smokers, smoking itself did not negatively impacted on the 1-year incidence of repeat PTA and amputations rates following successful PTA.