PMID- 34340657 OWN - NLM STAT- MEDLINE DCOM- 20211011 LR - 20211011 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 21 IP - 1 DP - 2021 Aug 2 TI - Risk stratification and mortality prediction in octo- and nonagenarians with peripheral artery disease: a retrospective analysis. PG - 370 LID - 10.1186/s12872-021-02177-1 [doi] LID - 370 AB - OBJECTIVES: Among changes in demographics, aging is the most relevant cardiovascular risk factor. The prevalence of peripheral artery disease (PAD) is high in elderly patients and is associated with a worse prognosis. Despite optimal treatments, mortality in the high-risk population of octo- and nonagenarians with PAD remains excessive, and predictive factors need to be identified. The objective of this study was to investigate predictors of mortality in octo- and nonagenarians with PAD. METHODS: Cases of treated octo- and nonagenarians, including the clinical characteristics and markers of myocardial injury and heart failure, were studied retrospectively with respect to all-cause mortality. Hazard ratios [HR] were calculated and survival was analyzed by Kaplan-Meyer curves and receiver operating characteristic curved were assessed for troponin-ultra and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and chronic limb-threatening ischemia (CLTI). RESULTS: A total of 123 octo- and nonagenarians admitted for PAD were eligible. The troponin level was the major predictor of all-cause mortality (HR: 4.6, 95% confidence interval [CI]: 1.4-15.3), followed by the NT-proBNP level (HR: 3.9, 95% CI 1.8-8.8) and CLTI (HR: 3.1, 95% CI 1.6-5.9). Multivariate regression revealed that each increment of 1 standard deviation in log troponin and log NT-proBNP was associated with a 2.7-fold (95% CI 1.8-4.1) and a 1.9-fold (95% CI 1.2-2.9) increased risk of all-cause death. Receiver operating characteristic curve analysis using a combination of all predictors yielded an improved area under the curve of 0.888. In a control group of an equal number of younger individuals, only NT-proBNP (HR: 4.2, 95% CI 1.2-14.1) and CLTI (HR: 6.1, 95% CI 1.6-23.4) were predictive of mortality. CONCLUSION: Our study demonstrates that cardiovascular biomarkers and CLTI are the primary predictors of increased mortality in elderly PAD patients. Further risk stratification through biomarkers in this high-risk population of octo- and nonagenarians with PAD is necessary. CI - (c) 2021. The Author(s). FAU - Rammos, Christos AU - Rammos C AD - Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. christos.rammos@uk-essen.de. FAU - Kontogiannis, Aristotelis AU - Kontogiannis A AD - Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. FAU - Mahabadi, Amir A AU - Mahabadi AA AD - Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. FAU - Steinmetz, Martin AU - Steinmetz M AD - Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. FAU - Messiha, Daniel AU - Messiha D AD - Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. FAU - Lortz, Julia AU - Lortz J AD - Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. FAU - Rassaf, Tienush AU - Rassaf T AD - Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. LA - eng PT - Journal Article DEP - 20210802 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 RN - 0 (Biomarkers) RN - 0 (Peptide Fragments) RN - 0 (Troponin) RN - 0 (pro-brain natriuretic peptide (1-76)) RN - 114471-18-0 (Natriuretic Peptide, Brain) SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - *Aging MH - Biomarkers/blood MH - Chronic Disease MH - Female MH - Humans MH - Ischemia/blood/diagnosis/*mortality MH - Male MH - Middle Aged MH - Natriuretic Peptide, Brain/blood MH - Peptide Fragments/blood MH - Peripheral Arterial Disease/blood/diagnosis/*mortality MH - Prognosis MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Troponin/blood PMC - PMC8330051 OTO - NOTNLM OT - Aging OT - Endovascular treatment OT - Mortality OT - Peripheral interventions COIS- The authors declare that they have no competing interests. EDAT- 2021/08/04 06:00 MHDA- 2021/10/12 06:00 PMCR- 2021/08/02 CRDT- 2021/08/03 05:33 PHST- 2020/12/02 00:00 [received] PHST- 2021/07/20 00:00 [accepted] PHST- 2021/08/03 05:33 [entrez] PHST- 2021/08/04 06:00 [pubmed] PHST- 2021/10/12 06:00 [medline] PHST- 2021/08/02 00:00 [pmc-release] AID - 10.1186/s12872-021-02177-1 [pii] AID - 2177 [pii] AID - 10.1186/s12872-021-02177-1 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2021 Aug 2;21(1):370. doi: 10.1186/s12872-021-02177-1.