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Beta-blocker Treatment Does Not Worsen Critical Limb Ischemia in Patients Receiving Endovascular Therapy

Yoshimitsu Soga1, Osamu Iida, Mitsuyoshi Takahara

  • 1Kokura Memorial Hospital, Department of Cardiology, Kitakyushu, Japan.

Journal of Atherosclerosis and Thrombosis
|December 3, 2014
PubMed

Insights

Beta-blocker (BB) therapy did not significantly alter amputation-free survival or limb salvage rates in critical limb ischemia (CLI) patients undergoing endovascular therapy (EVT). These findings suggest BBs are safe for CLI patients receiving EVT.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Pharmacology

Background:

  • Beta-blockers (BB) are known to reduce cardiovascular events in patients with atherosclerotic disease.
  • The efficacy of BBs in patients with critical limb ischemia (CLI) remains largely uninvestigated.
  • CLI patients often have significant comorbidities, making treatment decisions complex.

Purpose of the Study:

  • To investigate the impact of beta-blocker (BB) therapy on clinical outcomes in patients with critical limb ischemia (CLI).
  • To determine if BB use affects amputation-free survival (AFS), limb salvage, overall survival, and freedom from major adverse limb events (MALE) after endovascular therapy (EVT).

Main Methods:

  • Retrospective analysis of 1,873 CLI patients who underwent EVT for infrainguinal lesions between 2004 and 2011.
  • Propensity score analysis, including one-to-one matching (305 BB-treated vs. 305 non-BB-treated patients), was used for risk adjustment.
  • Primary endpoint was AFS; secondary endpoints included overall survival, limb salvage, and freedom from MALE. Mean follow-up was 22 months.

Main Results:

  • No significant differences in AFS at three years between BB-treated and non-BB-treated groups (58.8% vs. 58.5%, p=0.76).
  • Limb salvage rates (88.3% vs. 88.8%, p=0.41), overall survival (63.0% vs. 62.4%, p=0.70), and freedom from MALE (43.6% vs. 44.9%, p=0.58) were also similar between groups at three years.
  • Propensity score matching confirmed no detrimental effect of BB therapy on key clinical outcomes.

Conclusions:

  • Beta-blocker therapy does not appear to worsen clinical outcomes, including AFS and limb salvage, in CLI patients undergoing EVT.
  • These findings suggest that BBs can be safely continued or initiated in CLI patients undergoing EVT.
  • Further prospective studies may be warranted to confirm these results in a broader CLI population.
Abstract

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