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Mortality, Cardiovascular and Limb Events in Patients With Symptomatic Lower Extremity Artery Disease and Diabetes

François-Xavier Lapébie1,2, Vanina Bongard2,3,4, Philippe Lacroix5,6

  • 1Department of Vascular Medicine, 36760Toulouse University Hospital, Toulouse, France.

Angiology
|November 27, 2021
PubMed

Insights

Patients with diabetes hospitalized for lower extremity artery disease (LEAD) face significantly higher risks of major adverse cardiovascular events (MACE) and all-cause mortality compared to non-diabetic patients within one year. Diabetes status impacts overall prognosis after LEAD hospitalization.

Area of Science:

  • Vascular Medicine
  • Diabetology
  • Cardiovascular Epidemiology

Background:

  • Lower extremity artery disease (LEAD) is a significant cause of morbidity and mortality.
  • Diabetes mellitus is a known risk factor for cardiovascular disease and poorer outcomes in peripheral artery disease.
  • Understanding the impact of diabetes on prognosis after LEAD hospitalization is crucial for patient management.

Purpose of the Study:

  • To compare the 1-year prognosis of patients with and without diabetes after hospital admission for lower extremity artery disease (LEAD).
  • To assess the association of diabetes with major adverse cardiovascular events (MACE), all-cause mortality, and major limb amputation.

Main Methods:

  • Prospective cohort study (COPART registry) including 2494 patients admitted for LEAD.
  • Patients were categorized based on diabetes status (presence or absence).
  • 1-year follow-up data collected on MACE, all-cause mortality, and major limb amputations; statistical analysis included hazard ratios.

Main Results:

  • Diabetes was present in 49.5% of the 2494 patients.
  • Diabetic patients had higher incidence rates for MACE (18.0 vs. 11.1 per 100 person-years) and all-cause mortality (29.8 vs. 19.7 per 100 person-years).
  • Diabetes was associated with increased MACE (aHR 1.60) and all-cause mortality (uHR 1.49), but not significantly with major amputation in multivariate analysis (aHR 1.15).

Conclusions:

  • Patients hospitalized for lower extremity artery disease with diabetes exhibit a significantly higher risk of major adverse cardiovascular events compared to non-diabetic patients.
  • Diabetes is associated with an increased risk of all-cause mortality in this patient population.
  • While diabetes increases MACE and mortality risk, its independent association with major amputation was not confirmed in this study's multivariate analysis.

Keywords:
amputationcohort studiesdiabetes mellitusmajor adverse cardiovascular eventsmortalityperipheral artery disease

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