Body composition and mortality in patients undergoing endovascular treatment for peripheral artery disease

Abstract

An inverse correlation between body mass index and mortality in patients with peripheral artery disease (PAD) has been reported. However, little information is available regarding the impact of body composition on the clinical outcomes in patients with PAD. This study evaluated the relationships between the lean body mass index (LBMI), body fat % (BF%), and mortality and major amputation rate in patients with PAD. We evaluated 320 patients with PAD after endovascular treatment (EVT) enrolled from August 2015 to July 2016 and divided them into low and high LBMI and BF% groups based on their median values (17.47 kg/m2 and 22.07%, respectively). We assessed 3-year mortality and major amputation for the following patient groups: Low LBMI/Low BF%, Low LBMI/High BF%, High LBMI/Low BF%, and High LBMI/High BF%. During the median 3.1-year follow-up period, 70 (21.9%) patients died and 9 (2.9%) patients experienced major amputation. The survival rate was lower in the Low LBMI than in the High LBMI group, and was not significantly different between the Low and High BF% groups. Survival rates were lowest in the Low LBMI/Low BF% group (57.5%) and highest in the High LBMI/High BF% group (94.4%). There were no significant differences in major amputation rate between the Low LBMI and High LBMI groups, and between the Low BF% and High BF% groups. The Low LBMI and Low BF% groups were associated with an increased risk of mortality after adjustment for age, sex, frailty and conventional risk factors [hazard ratio (HR): 4.02; 95% confidence interval (CI) 2.10–7.70; p < 0.001 and HR: 4.48; 95% CI 1.58–12.68, p = 0.005, respectively], for age, sex, hemodialysis, and prior cerebral cardiovascular disease (HR: 3.63; 95% CI 1.93–6.82; p < 0.001 and HR: 4.03; 95% CI 1.43–11.42, p = 0.009, respectively) and for age, sex, and laboratory date (HR: 3.97; 95% CI 1.88–8.37; p < 0.001 and HR: 3.31; 95% CI 1.15–9.53, p = 0.026, respectively). In conclusion, Low LBMI and Low BF% were associated with poor prognosis in patients undergoing EVT for PAD, and mortality was the lowest in the High LBMI/High BF% group compared with other body composition groups.

Validation and Comparison of the Prognosis Predicting Ability of Inflammation-Based Scores Following Endovascular Treatment for Peripheral Artery Disease

“…The study definitions have been published. 22 GPS, mGPS, PLR, PI, and PNI were defined and scored as previously reported (Table 1). 23 GPS is defined as follows: patients with both elevated CRP (>1.0 mg/dl) and hypoalbuminemia (<3.5 g/dl) levels were assigned a score of 2.…”

Association between complete revascularization of the coronary artery and clinical outcomes in peripheral artery disease: a sub-analysis of the I-PAD Nagano registry

“…Baseline characteristicsData are shown as median [interquartile range], or n (percentage) CVD cerebrovascular disease, CLTI chronic limb threatening ischemia, LVEF left ventricular ejection fraction, ABI ankle-brachial index, eGFR estimated glomerular filtration rate, CRP C-reactive protein, BNP brain natriuretic peptide, LDL-C low density lipoprotein cholesterol, HDL-C high density lipoprotein cholesterol, TG triglyceride Cox regression analysis was performed to test the prognostic significance of complete revascularization for MACE. CR was adjusted by clinically important variables reported by previous studies[18][19][20][21][22]. A P value < 0.05 was considered statistically significant in all analyses.…”