Predictors of poor outcome in female patients undergoing endovascular intervention

Peripheral arterial disease (PAD) is widely accepted as an independent predictor of cardiovascular morbidity and mortality. The majority of subjects studied in PAD literature have been male, leaving female patients an underrepresented population with regard to revascularization outcomes and prognosis. The purpose of our study was to determine predictors of poor outcomes in female patients undergoing endovascular intervention (EI) for symptomatic PAD.

This study was conducted as a single-center retrospective chart review of 292 consecutive female patients who underwent EI for symptomatic PAD. Patient variables including baseline demographics, and procedural data were analyzed for statistical significance with regard to repeat EI including target vessel revascularization (TVR), amputation or vascular surgery, and death.

On multivariate analysis, increased preintervention creatinine > or =1.5 mg/dL (PRE-CR) and lower preprocedure hemoglobin were the strongest predictors of subsequent EI and TVR. Significant predictors for amputation or surgery included decreased body mass index (BMI) and increased Rutherford class at presentation. Only age, history of congestive heart failure (CHF), and PRE-CR remained significant predictors of mortality.

Our study is the first of its kind to specify predictors of poor outcomes after EI in female patients with symptomatic PAD. The strongest predictors of subsequent EI and TVR, limb loss, and vascular surgery, as well as death, were found to be chronic kidney disease (CKD; PRE-CR > 1.5 mg/dL), decreased BMI, Rutherford class, and anemia.