PMID- 37010808
OWN - NLM
STAT- MEDLINE
DCOM- 20230620
LR  - 20230620
IS  - 1868-4297 (Electronic)
IS  - 1868-4297 (Linking)
VI  - 38
IP  - 3
DP  - 2023 Jul
TI  - The association of calcium channel blocker with risk of adverse limb events in 
      patients with chronic limb-threatening ischemia after endovascular treatment.
PG  - 327-337
LID - 10.1007/s12928-023-00925-y [doi]
AB  - Symptoms of lower-extremity artery disease (LEAD) emerge from impaired 
      vascularization in distal circulation of the extremities. Calcium channel 
      blockers (CCB) can improve distal circulation when used as adjunctive therapy 
      with endovascular treatment (EVT), but few studies have evaluated that. We 
      investigated the relationship between CCB therapy and post-EVT outcomes. Through 
      a consecutive EVT registry, we evaluated those relationships in whole cohort and 
      the following 2 subgroups; the patients suffered from intermittent claudication 
      (IC) or chronic limb-threatening ischemia (CLTI), with adjusting baseline 
      characteristics by propensity score matchings. The primary endpoints were major 
      adverse cardiac and cerebrovascular events (MACCE, a composite endpoint of all 
      death, nonfatal myocardial infarction, and nonfatal stroke), and major adverse 
      limb event (MALE, a composite of major amputation, acute limb ischemia, and 
      surgical reintervention). The group that received CCB had less MALE in whole 
      cohort (HR 0.31; 95% confidence interval (CI) 0.20-0.47), and less MACCE and MALE 
      in CLTI cohort (HR 0.67; 0.50-0.89 and 0.32; 0.20-0.52 respectively) compared to 
      the group that did not receive CCB. The relationships were common in the cohorts 
      with baseline adjustment. MACCE and MALE in IC (HR 1.01; 0.57-1.80 and 0.60; 
      0.25-1.45, respectively) showed no significant differences both with and without 
      baseline adjustment. CCB use was related to fewer MACCE and MALE events in 
      adjusted patients who underwent EVT, and the trend was more evident, especially 
      in the adjusted CLTI cohort. This study highlights the necessity of future 
      studies regarding CCB. Clinical Trial Registration: URL: https://www.umin.ac.jp ; 
      Unique identifiers: UMIN000015100.
CI  - (c) 2023. The Author(s) under exclusive licence to Japanese Association of 
      Cardiovascular Intervention and Therapeutics.
FAU - Ueshima, Daisuke
AU  - Ueshima D
AUID- ORCID: 0000-0002-9204-5470
AD  - Department of Cardiology, Kameda Medical Center, 929 Higashityo, Chiba, 296-8602, 
      Japan. daisuke_ueshima@yahoo.co.jp.
FAU - Higashitani, Michiaki
AU  - Higashitani M
AD  - Department of Cardiology, Tokyo Medical University Ibaraki Medical Center, 
      Ibaraki, Japan.
FAU - Mizuno, Atsushi
AU  - Mizuno A
AD  - Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan.
FAU - Kodama, Takahide
AU  - Kodama T
AD  - Department of Cardiology, Toranomon Hospital, Tokyo, Japan.
FAU - Tobita, Kazuki
AU  - Tobita K
AD  - Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan.
FAU - Miyazaki, Toru
AU  - Miyazaki T
AD  - Department of Cardiology, Ome Municipal General Hospital, Tokyo, Japan.
FAU - Yamanaka, Tetsuo
AU  - Yamanaka T
AD  - Department of Cardiology, Tokyo Teishin Hospital, Tokyo, Japan.
FAU - Tara, Shuhei
AU  - Tara S
AD  - Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
FAU - Murata, Naotaka
AU  - Murata N
AD  - Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
FAU - Yamaguchi, Tetsuo
AU  - Yamaguchi T
AD  - Department of Cardiology, Toranomon Hospital, Tokyo, Japan.
CN  - Toma-Code Registry Investigators
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20230403
PL  - Japan
TA  - Cardiovasc Interv Ther
JT  - Cardiovascular intervention and therapeutics
JID - 101522043
RN  - 0 (Calcium Channel Blockers)
SB  - IM
MH  - Humans
MH  - Calcium Channel Blockers/adverse effects
MH  - Chronic Limb-Threatening Ischemia
MH  - *Endovascular Procedures/adverse effects
MH  - Ischemia/surgery
MH  - Limb Salvage
MH  - Lower Extremity/blood supply
MH  - *Peripheral Arterial Disease/diagnosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Adjunctive medical therapy
OT  - Calcium channel blocker
OT  - Endovascular treatment
OT  - Lower extremity artery disease
OT  - Vasodilator
EDAT- 2023/04/04 06:00
MHDA- 2023/06/09 06:41
CRDT- 2023/04/03 11:25
PHST- 2022/09/12 00:00 [received]
PHST- 2023/03/04 00:00 [accepted]
PHST- 2023/06/09 06:41 [medline]
PHST- 2023/04/04 06:00 [pubmed]
PHST- 2023/04/03 11:25 [entrez]
AID - 10.1007/s12928-023-00925-y [pii]
AID - 10.1007/s12928-023-00925-y [doi]
PST - ppublish
SO  - Cardiovasc Interv Ther. 2023 Jul;38(3):327-337. doi: 10.1007/s12928-023-00925-y. 
      Epub 2023 Apr 3.