PMID- 34004125
OWN - NLM
STAT- MEDLINE
DCOM- 20220309
LR  - 20221207
IS  - 1477-0377 (Electronic)
IS  - 1358-863X (Print)
IS  - 1358-863X (Linking)
VI  - 26
IP  - 5
DP  - 2021 Oct
TI  - Diabetes mellitus was not associated with lower amputation-free survival after 
      open revascularization for chronic limb-threatening ischemia - A nationwide 
      propensity score adjusted analysis.
PG  - 507-514
LID - 10.1177/1358863X211008249 [doi]
AB  - The risk of major amputation is higher after urgently planned endovascular 
      therapy for chronic limb-threatening ischemia (CLTI) in patients with diabetes 
      mellitus (DM). The aim of this nationwide cohort study was to compare outcomes 
      between patients with and without DM following urgently planned open 
      revascularization for CLTI from 2010 to 2014. Out of 1537 individuals registered 
      in the Swedish Vascular Registry, 569 were registered in the National Diabetes 
      Register. A propensity score adjusted Cox regression analysis was conducted to 
      compare outcome between the groups with and without DM. Median follow-up was 4.3 
      years and 4.5 years for patients with and without DM, respectively. Patients with 
      DM more often had foot ulcers (p = 0.034) and had undergone more previous 
      amputations (p = 0.001) at baseline. No differences in mortality, cardiovascular 
      death, major adverse cardiovascular events (MACE), or major amputation were 
      observed between groups. The incidence rate of stroke was 70% higher (95% CI: 
      1.11-2.59; p = 0.0137) and the incidence rate of acute myocardial infarction 
      (AMI) 39% higher (95% CI: 1.00-1.92; p = 0.0472) among patients with DM in 
      comparison to those without. Open vascular surgery remains a first-line option 
      for a substantial number of patients with CLTI, especially for limb salvage in 
      patients with DM. The higher incidence rates of stroke and AMI among patients 
      with DM following open vascular surgery for infrainguinal CLTI require specific 
      consideration preoperatively with the aim of optimizing medical treatment to 
      improve cardiovascular outcome postoperatively.
FAU - Lilja, Erika
AU  - Lilja E
AUID- ORCID: 0000-0001-9965-8133
AD  - Department of Clinical Sciences, Lund University, Malmo, Sweden.
FAU - Gottsater, Anders
AU  - Gottsater A
AUID- ORCID: 0000-0003-0865-0000
AD  - Department of Clinical Sciences, Lund University, Malmo, Sweden.
AD  - Department of Cardio-Thoracic Surgery and Vascular Diseases, Vascular Center, 
      Skane University Hospital, Malmo, Sweden.
FAU - Miftaraj, Mervete
AU  - Miftaraj M
AD  - Centre of Registers, National Diabetes Register, Goteborg, Sweden.
FAU - Ekelund, Jan
AU  - Ekelund J
AD  - Centre of Registers, National Diabetes Register, Goteborg, Sweden.
FAU - Eliasson, Bjorn
AU  - Eliasson B
AD  - Department of Molecular and Clinical Medicine, Institute of Medicine, University 
      of Gothenburg, Goteborg, Sweden.
FAU - Svensson, Ann-Marie
AU  - Svensson AM
AD  - Centre of Registers, National Diabetes Register, Goteborg, Sweden.
AD  - Department of Molecular and Clinical Medicine, Institute of Medicine, University 
      of Gothenburg, Goteborg, Sweden.
FAU - Zarrouk, Moncef
AU  - Zarrouk M
AD  - Department of Clinical Sciences, Lund University, Malmo, Sweden.
AD  - Department of Cardio-Thoracic Surgery and Vascular Diseases, Vascular Center, 
      Skane University Hospital, Malmo, Sweden.
FAU - Acosta, Stefan
AU  - Acosta S
AUID- ORCID: 0000-0002-3225-0798
AD  - Department of Clinical Sciences, Lund University, Malmo, Sweden.
AD  - Department of Cardio-Thoracic Surgery and Vascular Diseases, Vascular Center, 
      Skane University Hospital, Malmo, Sweden.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210518
PL  - England
TA  - Vasc Med
JT  - Vascular medicine (London, England)
JID - 9610930
SB  - IM
MH  - Amputation, Surgical
MH  - Chronic Limb-Threatening Ischemia
MH  - Cohort Studies
MH  - *Diabetes Mellitus/diagnosis/epidemiology
MH  - *Endovascular Procedures
MH  - Humans
MH  - Ischemia/diagnosis/surgery
MH  - Limb Salvage
MH  - *Peripheral Arterial Disease/diagnosis/surgery
MH  - Propensity Score
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC8493412
OTO - NOTNLM
OT  - amputation
OT  - bypass
OT  - chronic limb-threatening ischemia (CLTI)
OT  - diabetes mellitus
COIS- Declaration of conflicting interests: The authors declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2021/05/19 06:00
MHDA- 2022/03/11 06:00
PMCR- 2021/10/06
CRDT- 2021/05/18 20:23
PHST- 2021/05/19 06:00 [pubmed]
PHST- 2022/03/11 06:00 [medline]
PHST- 2021/05/18 20:23 [entrez]
PHST- 2021/10/06 00:00 [pmc-release]
AID - 10.1177_1358863X211008249 [pii]
AID - 10.1177/1358863X211008249 [doi]
PST - ppublish
SO  - Vasc Med. 2021 Oct;26(5):507-514. doi: 10.1177/1358863X211008249. Epub 2021 May 
      18.