Long-Term Outcomes and Associations With Major Adverse Limb Events After Peripheral Artery Revascularization

Area of Science:

• Vascular Surgery
• Cardiology
• Health Outcomes Research

Background:

• Long-term outcomes after peripheral artery disease revascularization are not well-established.
• Prognosis following major adverse limb events (MALE) after revascularization requires further study.

Purpose of the Study:

• To describe long-term cardiovascular and limb outcomes after peripheral artery disease revascularization.
• To assess the impact of post-procedure MALE hospitalization on subsequent cardiovascular and limb events.

Main Methods:

• Retrospective cohort study of 393,017 patients undergoing peripheral revascularization (2009-2015).
• Co-primary outcomes: composite myocardial infarction (MI) or stroke, and composite major amputation or repeat revascularization.
• Cox proportional hazards models with MALE hospitalization as a time-dependent covariate were used.

Main Results:

• Cumulative incidence of MI/stroke was 9.8%; major amputation/revascularization was 41.9%.
• 12.9% of patients experienced at least one post-procedure MALE hospitalization.
• MALE hospitalization significantly increased risk of subsequent MI/stroke (HR 1.34) and major amputation/revascularization (HR 8.13).

Conclusions:

• Peripheral artery disease patients face early limb and later cardiac ischemic risks post-revascularization.
• Post-procedure MALE hospitalization substantially elevates the risk of subsequent adverse cardiovascular and limb events.
• Enhanced provider awareness of these risks is crucial for improving patient outcomes.