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Methods for Acute and Subacute Murine Hindlimb Ischemia
Published on: June 21, 2016
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Sex-related differences in treatment and outcome of chronic limb-threatening ischaemia: a real-world cohort
Lena Makowski1, Jeanette Köppe2, Christiane Engelbertz1
1Department of Cardiology I-Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol, Albert Schweitzer Campus 1, A1, 48149 Muenster, Germany.
European Heart Journal
|February 8, 2022
Summary
Despite older age and fewer vascular procedures, female patients with chronic limb-threatening ischemia (CLTI) had better survival rates. This study highlights sex-related differences in CLTI risk, treatment, and outcomes.
Area of Science:
- Vascular Surgery
- Cardiology
- Epidemiology
Background:
- Chronic limb-threatening ischemia (CLTI) is a growing concern with increasing prevalence.
- Existing data on CLTI often comes from cohorts with varied selection criteria, necessitating studies on unselected populations.
- Understanding sex-related differences in CLTI is crucial for optimizing patient care and outcomes.
Purpose of the Study:
- To investigate sex-based disparities in the risk profile of patients diagnosed with CLTI.
- To analyze differences in vascular procedures and treatments received by male and female CLTI patients.
- To evaluate the long-term survival outcomes (overall survival and amputation-free survival) between sexes in CLTI patients.
Main Methods:
- Analysis of a large, unselected cohort of 199,953 patients hospitalized for CLTI between 2010 and 2017, sourced from Germany's largest public health insurance (AOK).
- Inclusion of a 2-year pre-index hospitalization baseline period for comorbidity assessment and a follow-up period extending to 2018.
- Utilized Cox regression analysis to assess the independent association of female sex with overall survival (OS) and amputation-free survival (AFS), adjusting for age and comorbidities.
Main Results:
- Female CLTI patients were significantly older (median 81.4 vs. 73.8 years) and presented with higher rates of hypertension, atrial fibrillation, chronic heart failure, and chronic kidney disease.
- Male patients more frequently had diabetes mellitus, dyslipidaemia, were smokers, and had cerebrovascular disease or chronic coronary syndrome.
- Women underwent fewer diagnostic angiographies (67% vs. 70%) and revascularization procedures (61% vs. 65%), and received less guideline-recommended medication (statins, antithrombotics) compared to men.
Conclusions:
- Female patients with CLTI are older, undergo fewer vascular procedures, and receive less guideline-recommended medication.
- Despite these factors, female sex was independently associated with improved overall survival and amputation-free survival in CLTI patients.
- These findings underscore the importance of considering sex as a biological variable in CLTI research and clinical practice.
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