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Association of lower extremity arterial calcification with amputation and mortality in patients with symptomatic

Chi-Lun Huang1, I-Hui Wu2, Yen-Wen Wu3

  • 1Department of Internal Medicine, Taoyuan General Hospital, Taoyuan City, Taiwan ; Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan ; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei City, Taiwan.

Plos One
|March 4, 2014
PubMed

Insights

Lower extremity arterial calcification scores predict amputation and mortality in peripheral artery disease patients. Higher scores indicate increased risk, even after adjusting for traditional risk factors.

Area of Science:

  • Vascular Medicine
  • Radiology
  • Cardiovascular Imaging

Background:

  • Coronary artery calcium scoring (CS) is clinically established.
  • The role of lower extremity arterial calcification in predicting outcomes is less understood.

Purpose of the Study:

  • To investigate the association between lower extremity arterial calcification and clinical outcomes in patients with symptomatic peripheral artery disease (PAD).

Main Methods:

  • Retrospective analysis of noncontrast multidetector computed tomography (MDCT) images in 82 symptomatic PAD patients.
  • CSs were quantified from the iliac bifurcation to the ankle.
  • Primary endpoints were amputation and all-cause mortality over a 21-month follow-up.

Main Results:

  • Higher CSs were associated with older age, diabetes, hyperlipidemia, end-stage renal disease, and advanced Fontaine stages.
  • Patients in the highest quartile of CS had a significantly higher risk of amputation (2.88-fold) and all-cause mortality (5.16-fold) compared to the lowest quartile.
  • These associations remained significant after adjusting for conventional risk factors.

Conclusions:

  • Lower extremity arterial CSs are linked to disease severity and adverse outcomes in symptomatic PAD.
  • CSs demonstrate independent predictive value for amputation and mortality in this patient group.
  • Further large-scale prospective studies are warranted to confirm these findings.
Abstract

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