PMID- 36948637
OWN - NLM
STAT- MEDLINE
DCOM- 20231103
LR  - 20231108
IS  - 1880-3873 (Electronic)
IS  - 1340-3478 (Print)
IS  - 1340-3478 (Linking)
VI  - 30
IP  - 11
DP  - 2023 Nov 1
TI  - Association between High Bleeding Risk and 2-Year Mortality in Patients with 
      Chronic Limb-Threatening Ischemia.
PG  - 1674-1686
LID - 10.5551/jat.64157 [doi]
AB  - AIM: Patients with chronic limb-threatening ischemia (CLTI) have a high bleeding 
      risk (HBR) and mortality rate. The 2-year life expectancy is an important factor 
      in deciding the appropriate treatment strategy. This study aimed to assess the 
      influence of HBR on the prognosis of patients with CLTI. METHODS: A total of 259 
      patients with CLTI who underwent endovascular therapy (EVT) (mean age, 76.2 
      years; male, 62.9%) between January 2018 and December 2019 were evaluated. The 
      Academic Research Consortium for HBR (ARC-HBR) criteria were applied to each 
      patient, and the ARC-HBR scores were calculated. The cut-off score for predicting 
      all-cause mortality within two years was derived using a survival classification 
      and regression tree (CART) model. Causes of death and the association between 
      ARC-HBR scores and major bleeding events within two years were also investigated. 
      RESULTS: Based on the CART model, patients were divided into three groups (low 
      HBR score 0-1.0, 48 patients; moderate HBR score 1.5-3.0, 176 patients; and high 
      HBR score >/= 3.5, 35 patients). During the study period, 82 patients (39.6%) died 
      due to cardiac (n=23) and non-cardiac causes (n=59). All-cause mortality 
      increased significantly with increasing ARC-HBR scores. Cox multivariate analysis 
      revealed a significant association between high ARC-HBR scores and the risk of 
      all-cause mortality within two years. Major bleeding events increased 
      significantly with increasing ARC-HBR scores. CONCLUSIONS: The ARC-HBR score 
      could predict 2-year mortality in patients with CLTI who underwent EVT. Thus, 
      this score can help determine the best revascularization strategy for patients 
      with CLTI.
FAU - Yoshioka, Naoki
AU  - Yoshioka N
AD  - Department of Cardiology, Ogaki Municipal Hospital.
FAU - Tokuda, Takahiro
AU  - Tokuda T
AD  - Department of Cardiology, Nagoya Heart Center.
FAU - Koyama, Akio
AU  - Koyama A
AD  - Department of Vascular Surgery, Ichinomiya Municipal Hospital.
FAU - Yamada, Takehiro
AU  - Yamada T
AD  - Department of Cardiology, Central Japan International Medical Center.
FAU - Shimamura, Kiyotaka
AU  - Shimamura K
AD  - Department of Cardiology, Shizuoka General Hospital.
FAU - Nishikawa, Ryusuke
AU  - Nishikawa R
AD  - Department of Cardiovascular of Medicine, Kyoto University Graduate School of 
      Medicine.
FAU - Morita, Yasuhiro
AU  - Morita Y
AD  - Department of Cardiology, Ogaki Municipal Hospital.
FAU - Morishima, Itsuro
AU  - Morishima I
AD  - Department of Cardiology, Ogaki Municipal Hospital.
LA  - eng
PT  - Journal Article
DEP - 20230322
PL  - Japan
TA  - J Atheroscler Thromb
JT  - Journal of atherosclerosis and thrombosis
JID - 9506298
SB  - IM
MH  - Humans
MH  - Aged
MH  - Chronic Limb-Threatening Ischemia
MH  - Ischemia/surgery
MH  - Treatment Outcome
MH  - *Peripheral Arterial Disease/surgery
MH  - Risk Factors
MH  - Hemorrhage/complications
MH  - Risk Assessment
MH  - Retrospective Studies
MH  - Limb Salvage
MH  - *Endovascular Procedures/adverse effects
PMC - PMC10627769
OTO - NOTNLM
OT  - Chronic limb-threatening ischemia
OT  - Endovascular therapy
OT  - High bleeding risk
OT  - Lower extremity artery disease
OT  - Mortality
COIS- The authors declare that they have no conflict of interest.
EDAT- 2023/03/23 06:00
MHDA- 2023/11/03 06:44
PMCR- 2023/11/01
CRDT- 2023/03/22 21:46
PHST- 2023/11/03 06:44 [medline]
PHST- 2023/03/23 06:00 [pubmed]
PHST- 2023/03/22 21:46 [entrez]
PHST- 2023/11/01 00:00 [pmc-release]
AID - DN/JST.JSTAGE/jat/64157 [pii]
AID - 10.5551/jat.64157 [doi]
PST - ppublish
SO  - J Atheroscler Thromb. 2023 Nov 1;30(11):1674-1686. doi: 10.5551/jat.64157. Epub 
      2023 Mar 22.