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Prognostic Significance of Atrial Fibrillation in Lower Limb Amputee Patients

S Ralevic1, J Perunicic2, R Lasica3

  • 1Specialized Hospital for Rehabilitation and Orthopedic Prosthetics, Belgrade, Serbia.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|October 30, 2016
PubMed

Insights

Atrial fibrillation (AF) is prevalent in patients with lower limb amputation (LLA), increasing their risk of adverse cardiovascular events. Early detection and management of AF in LLA patients are crucial for improving long-term outcomes.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Epidemiology

Background:

  • Atrial fibrillation (AF) is linked to poor prognosis in patients with atherothrombosis.
  • Lower limb amputation (LLA) is a serious condition often associated with cardiovascular risk factors.

Purpose of the Study:

  • To determine the prevalence of AF in patients undergoing major LLA.
  • To investigate the association between AF and long-term cardiovascular outcomes, including death and adverse events, in LLA patients.

Main Methods:

  • An observational prospective study included consecutive patients undergoing major LLA (transfemoral or transtibial).
  • The primary endpoint was cardiovascular death; secondary endpoints included a composite of acute myocardial infarction, contralateral LLA, and ischemic stroke.
  • Follow-up was conducted to assess long-term cardiovascular events.

Main Results:

  • Of 282 LLA patients, 16.3% had AF. AF patients were older and less likely to have diabetes or smoke compared to non-AF patients.
  • At a median follow-up of 24 months, patients with AF had a higher incidence of cardiovascular death (28.3% vs. 17.8%) and adverse cardiovascular events (32.6% vs. 22.0%).
  • Multivariate analysis identified AF and diabetes as independent predictors of adverse cardiovascular events.

Conclusions:

  • Atrial fibrillation is common in patients with lower limb amputation.
  • AF is significantly associated with an increased risk of adverse cardiovascular events and cardiovascular death in the long-term follow-up of LLA patients.
Abstract

Keywords:
Adverse cardiovascular eventsAmputationAtrial fibrillation

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