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Peripheral arterial disease (PAD) is known to be associated with poor outcomes due to higher incidence of combined cardiovascular morbidity and mortality. We evaluated the impact of the use of renin-angiotensin-aldosterone (RAS) blocker on clinical outcomes in patients (pts) with PAD who underwent percutaneous transluminal angioplasty (PTA).
The outcomes of 559 consecutive pts with symptomatic PAD who underwent PTA were enrolled for analysis. Pts were divided into two groups according to use of RAS blocker; PAD with RAS blocker (n=309) and PAD without RAS blocker (n=250). The incidence of restenosis, amputation rates and clinical outcomes were assessed at a follow-up of 1 year.
PAD pts using RAS blocker had suffered from more diabetes mellitus (DM, 58.9% vs. 41.1%; p=0.004), coronary artery disease (CAD, 62.1% vs.47.6%; p=0.001), treated with percutaneous coronary intervention (PCI, 31.4% vs. 23.2%; p=0.036), myocardial infarction (MI, 8.7% vs.3.2%, p=0.008), and the use of beta blocker (40.8% vs. 14.8%; p<0.001) and statin (86.7%, vs. 80.4%, p=0.049). The incidence of claudication and resting pain as the initial diagnosis for PAD were similar between the two groups. At 8 months follow-up, the incidence of primary patency were higher in PAD pts using RAS blocker (54.8% vs. 37.8%; p=0.027). At 1-year follow up, the incidence of repeat PTA, amputation rate, and major adverse cardiovascular events (MACE) were similar between the two groups.
In this study, although PTA pts using RAS blocker had more traditional cardiovascular risks, the incidence of restenosis, amputation rate, and MACE at 1 years were similar between the two groups. Therefore, the use of RAS blocker may be useful to improve clinical outcomes in significant PAD pts underwent PTA.