COPART Risk Score Predicts Long-term Mortality in Peripheral Arterial Occlusive Disease

Area of Science:

• Vascular Surgery
• Cardiology
• Clinical Risk Stratification

Background:

• Peripheral arterial occlusive disease (PAOD) requires effective risk assessment for patient management.
• The COhorte de Patients ARTériopathes (COPART) Risk Score was developed to evaluate 1-year outcomes in hospitalized PAOD patients.
• The score incorporates six key variables: age, myocardial infarction history, C-reactive protein, ankle-brachial index, estimated glomerular filtration rate, and specific medications.

Purpose of the Study:

• To validate the COPART Risk Score's ability to predict long-term all-cause and cardiovascular (CV) mortality.
• To assess the score's utility in claudicant patients undergoing their first endovascular intervention.

Main Methods:

• A prospective trial included 129 consecutive claudicant patients hospitalized for endovascular procedures.
• Follow-up averaged 8.8 years, with endpoints including all-cause mortality and CV death.
• Patients were categorized into low, medium, and high-risk groups based on the COPART Risk Score.

Main Results:

• Significant differences in all-cause mortality were observed across risk groups (low: 23.1%, medium: 34.1%, high: 63.9%).
• Cardiovascular death rates also varied significantly by risk group (low: 11.5%, medium: 22.0%, high: 41.7%).
• Statistical analysis confirmed significant differences in mortality between the three risk cohorts (p < .0001 for all-cause, p = .001 for CV death).

Conclusions:

• The COPART Risk Score is a validated tool for predicting long-term all-cause and cardiovascular mortality.
• It is suitable for claudicant patients prior to their initial peripheral endovascular intervention.
• The score aids in stratifying risk and potentially guiding treatment strategies for PAOD.