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Peripheral vascular disease and one-year mortality following percutaneous coronary revascularization
John H Chiu1, Eric J Topol, Patrick L Whitlow
1Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Insights
Peripheral vascular disease significantly increases mortality risk following coronary stent procedures. Patients with peripheral vascular disease face a two- to threefold higher chance of death one year after percutaneous coronary intervention.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Peripheral vascular disease (PVD) is a common condition affecting arteries outside the heart.
- PVD may influence patient outcomes after coronary interventions.
- The TARGET trial provides data to assess this association.
Purpose of the Study:
- To investigate the impact of peripheral vascular disease on outcomes after percutaneous coronary intervention (PCI).
- To quantify the risk associated with PVD in patients undergoing PCI.
Main Methods:
- Analysis of data from the Do Tirofiban and Reopro Give Similar Efficacy Outcome Trial (TARGET).
- Utilized multivariate modeling to adjust for confounding factors.
- Examined mortality rates at 1 year post-PCI.
Main Results:
- A history of peripheral vascular disease was independently associated with increased mortality.
- Patients with PVD had a two- to threefold higher risk of death at 1 year after PCI.
- These findings remained significant after statistical adjustments.
Conclusions:
- Peripheral vascular disease is a significant predictor of adverse outcomes, including mortality, after percutaneous coronary intervention.
- Cardiovascular risk stratification should consider the presence of PVD in patients undergoing PCI.
- Further research may explore specific management strategies for PVD patients undergoing PCI.
Abstract:
The association between peripheral vascular disease and outcomes after percutaneous coronary intervention was examined in the Do Tirofiban and Reopro Give Similar Efficacy Outcome Trial (TARGET). After adjustments in a multivariate model, a history of peripheral vascular disease was found to be associated with a two- to threefold increase in mortality at 1 year after coronary stent placement.