2nd Department of Cardiology, Jagiellonian University Collegium Medicum, Krakow, Poland.
Semmelweis University, Heart and Vascular Center, Cardiology Department, Hungary.
J Diabetes Res. 2019 Mar 31;2019:6036359. doi: 10.1155/2019/6036359. eCollection 2019.
The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: = 45 vs. non-CAD group: = 41) and DM (DM group: = 50 vs. non-DM group: = 36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) ( value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.
外周动脉疾病(PAD)患者最相关的合并症是冠状动脉疾病(CAD)和糖尿病(DM)。然而,慢性完全闭塞(CTO)患者长期随访的数据很少。本研究的目的是评估 CAD 和 DM 对外周动脉疾病患者股浅动脉(SFA)CTO 逆行再通后长期随访的影响。在这项研究中,共有 86 名患有 PAD 的患者,其股腘区有确诊的 CTO,并且至少有一次顺行再通尝试失败,他们在 2 个临床中心被纳入研究。所有患者的平均随访时间为 47.5 个月(±40 个月)。根据 CAD 的存在(CAD 组:n=45 例 vs. 非 CAD 组:n=41 例)和 DM(DM 组:n=50 例 vs. 非 DM 组:n=36 例)将患者分为两组。在长期随访中,CAD 组有 66.6%的患者发生主要不良外周事件(MAPE),而非 CAD 组为 36.5%;DM 组有 50%的患者发生 MAPE,而非 DM 组为 55%。两组在周围终点方面无统计学差异。然而,在全因死亡率方面存在统计学显著差异:DM 组有 6 例死亡(12%)( 值=0.038)。总之,在逆行再通后合并 CTO 和 DM 的患者,在长期随访中死亡风险更高。