Adverse Prognosis of Peripheral Artery Disease Treatments Associated With Diabetes: A Comprehensive Meta-Analysis

Abstract

Many studies have investigated the influence of diabetes mellitus (DM) on outcomes in patients with peripheral artery disease (PAD). We performed a meta-analysis of the outcomes of PAD treatments in DM patients compared with those without DM. Long-term mortality was the primary endpoint. Secondary endpoints were in-hospital/30-day mortality, primary/secondary patency, amputation, and limb salvage. Thirty-one studies reporting 58113 patients were eligible for enrollment. The mean follow-up duration ranged from 1 to 89 months. DM was significantly associated with long-term mortality (relative risk (RR) = 1.67; 95% confidence intervals (CI), 1.43–1.94; P < .001). DM was also associated with significantly lower primary patency (RR = 0.74; 95% CI, 0.58–0.95; P = .001) and secondary patency (RR = 0.80; 95% CI, 0.67–0.96; P = .009). DM is associated with worse outcomes and adverse prognosis of treatment in patients with PAD, and may therefore be a modifiable risk factor for poor prognosis in PAD patients.

Temporal trends in patients with peripheral artery disease influenced by diabetes mellitus in Germany

“… 28 In accordance, presence of DM in PAD patients resulted in a 67% increase of long‐term mortality in a recently published meta‐analysis. 29 The present findings also confirm a prior German study on data of a large health incurrence company in which the time period within 2009–2011 was analyzed. 30 Similar to our results, Richter et al identified DM as a substantial risk factor for morbidity and mortality in patients with PAD.…”

“…An Austrian study revealed a 2.5‐fold elevated risk for death within 10 years in patients with PAD and DM compared to nondiabetic PAD patients 28 . In accordance, presence of DM in PAD patients resulted in a 67% increase of long‐term mortality in a recently published meta‐analysis 29 . The present findings also confirm a prior German study on data of a large health incurrence company in which the time period within 2009–2011 was analyzed 30 .…”

Diabetes Mellitus and Its Impact on Patient-Profile and In-Hospital Outcomes in Peripheral Artery Disease

“…Further, PAD patients with DM are more likely to receive major and minor amputations compared to patients without DM [ 15 ]. In a recent meta-analysis including more than 58,000 PAD patients from 31 studies, DM was associated with a 67% elevated long-term mortality [ 16 ]. While temporal trend analysis revealed a decrease of symptomatic PAD incidence and prevalence in the general population [ 8 ], a Canadian study found no decrease of PAD-associated hospitalizations between 2006 and 2019 in people with diabetes [ 17 ].…”

Impact of Diabetes on Outcomes of Patients With Lower Extremity Artery Disease

“…A meta-analysis including 31 studies with 58 113 patients recently compared the outcomes after LEAD treatment in diabetic patients with those without diabetes. 6 For a mean follow-up duration ranging from 1 to 89 months, diabetes was significantly associated with long-term mortality (relative risk (RR) = 1.67; 95% confidence interval (CI), 1.43–1.94; P < .001). 6 Diabetes was also significantly associated with lower primary and secondary patency.…”

“…6 For a mean follow-up duration ranging from 1 to 89 months, diabetes was significantly associated with long-term mortality (relative risk (RR) = 1.67; 95% confidence interval (CI), 1.43–1.94; P < .001). 6 Diabetes was also significantly associated with lower primary and secondary patency.…”