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Methods for Acute and Subacute Murine Hindlimb Ischemia
Published on: June 21, 2016
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Acute Limb Ischemia in Peripheral Artery Disease
Connie N Hess1, Zhen Huang2, Manesh R Patel2
1Division of Cardiology, Department of Medicine, University of Colorado School of Medicine and CPC Clinical Research, Aurora (C.N.H., W.R.H.).
Circulation
|June 27, 2019
Summary
Acute limb ischemia (ALI) risk is higher in patients with prior revascularization, atrial fibrillation, or low ankle-brachial index. ALI hospitalization significantly increases risks for cardiovascular events, mortality, and amputation.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Clinical Trial Analysis
Background:
- Acute limb ischemia (ALI) is a critical clinical event and an emerging outcome in cardiovascular trials.
- Comprehensive evaluation of ALI risk factors and outcomes is needed.
Purpose of the Study:
- To identify baseline factors associated with ALI hospitalization in patients with peripheral artery disease (PAD).
- To analyze the impact of ALI hospitalization on subsequent major adverse cardiovascular events (MACE), all-cause mortality, and major amputation.
Main Methods:
- Analysis of 13,885 patients from the EUCLID trial (ticagrelor vs. clopidogrel) in PAD.
- Cox proportional hazards modeling to identify ALI risk factors.
- Development of models for secondary outcomes using ALI hospitalization as a time-dependent covariate.
Main Results:
- 1.7% of patients experienced 293 ALI hospitalizations; higher risk associated with previous revascularization, atrial fibrillation, and lower ankle-brachial index (ABI ≤ 0.60).
- Older age and statin use were associated with lower ALI risk.
- ALI hospitalization was linked to increased MACE (HR 1.4), all-cause mortality (HR 3.3), and major amputation (HR 34.2).
Conclusions:
- Previous peripheral revascularization, baseline atrial fibrillation, and low ABI identify PAD patients at high risk for ALI.
- ALI is a significant predictor of subsequent cardiovascular and limb-related morbidity and mortality.
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