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

Heart Vessels. 2023 Aug;38(8):1001-1008. doi: 10.1007/s00380-023-02251-y. Epub 2023 Apr 13.

Abstract

Peripheral artery disease (PAD) is commonly caused by atherosclerosis and has an unfavorable prognosis. Complete revascularization (CR) of the coronary artery reduces the risk of major adverse cardiovascular event (MACE) in patients with coronary artery disease (CAD). However, the impact of CR in patients with PAD has not been established to date. Therefore, we evaluated the impact of CR of CAD on the five-year clinical outcomes in patients with PAD. This study was based on a prospective, multicenter, observational registry in Japan. We enrolled 366 patients with PAD undergoing endovascular treatment. The primary endpoint was MACE, defined as a composite of all-cause death, non-fatal myocardial infarction, and non-fatal stroke. After excluding ineligible patients, 96 and 68 patients received complete revascularization of the coronary artery (CR group) and incomplete revascularization of the coronary artery (ICR group), respectively. Freedom from MACE in the CR group was significantly higher than in the ICR group at 5 years (66.7% vs 46.0%, p < 0.01). Multivariate analysis revealed that CR emerged as an independent predictor of MACE (Hazard ratio: 0.56, 95% confidential interval: 0.34-0.94, p = 0.03). CR of CAD was significantly associated with improved clinical outcomes in patients with PAD undergoing endovascular treatment.

Keywords: Complete revascularization; Coronary artery disease; Endovascular therapy; Major adverse cardiovascular events; Peripheral artery disease.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Coronary Artery Disease* / complications
  • Coronary Artery Disease* / surgery
  • Humans
  • Peripheral Arterial Disease* / complications
  • Peripheral Arterial Disease* / diagnosis
  • Peripheral Arterial Disease* / surgery
  • Prospective Studies
  • Registries
  • Risk Factors
  • Treatment Outcome