PMID- 37532569
OWN - NLM
STAT- MEDLINE
DCOM- 20240105
LR  - 20240112
IS  - 1880-3873 (Electronic)
IS  - 1340-3478 (Print)
IS  - 1340-3478 (Linking)
VI  - 31
IP  - 1
DP  - 2024 Jan 1
TI  - Chronic Limb-Threatening Ischemia is a Residual Bleeding Risk Factor among 
      Patients with Lower Extremity Artery Disease.
PG  - 100-108
LID - 10.5551/jat.64242 [doi]
AB  - AIM: Lower-extremity artery disease (LEAD) is a high-risk factor for bleeding. 
      However, the specific risk factors for bleeding in patients with LEAD remain 
      unclear. We aimed to identify risk factors for bleeding in patients with LEAD 
      after endovascular treatment (EVT). METHODS: This multicenter, retrospective, 
      observational study included 732 consecutive patients with LEAD who underwent EVT 
      between January 2018 and December 2019. Patient characteristics, laboratory data, 
      target lesions, and medications were compared between patients with and without 
      chronic limb-threatening ischemia (CLTI). Predictive bleeding risk factors were 
      explored using Cox regression analysis with differential models. RESULTS: In 
      model 1, a body mass index (BMI) ＜18.5 kg/m(2), prior heart failure, high 
      bleeding risk, use of single antiplatelet therapy (SAPT) plus warfarin, and CLTI 
      were predictive bleeding risk factors (hazard ratio [HR] 2.05; 95% confidence 
      interval [CI] 1.13-3.52; p＜0.01; HR 2.15; 95% CI 1.28-3.55; p＜0.01; HR 3.40; 95% 
      CI 1.28-3.55; p＜0.01; HR 2.05; 95% CI 1.33-5.84; p＜0.01; respectively). In model 
      2, a BMI ＜18.5 kg/m(2), prior heart failure, anemia (＜11 g/dL), low platelet 
      count (＜10*10(4)/microL), chronic kidney disease, use of single antiplatelet therapy 
      (SAPT) plus warfarin, and CLTI were independent risk factors for bleeding (model 
      2: HR 2.05; 95% CI 1.12-3.56; p=0.02; HR 2.35; 95% CI 1.39-3.90; p＜0.01; HR 2.71; 
      95% CI 1.64-4.50; p＜0.01; HR 2.66; 95% CI 1.00-5.89; p=0.05; HR 2.47; 95% CI 
      1.25-5.45; p＜0.01; HR 2.79; 95% CI 1.24-5.63; p=0.01; respectively) Conclusions: 
      CLTI is a residual and predictive risk factor for bleeding in patients with LEAD. 
      We have to pay attention to the bleeding events of patients with CLTI after EVT 
      during follow-up.
FAU - Tokuda, Takahiro
AU  - Tokuda T
AD  - Department of Cardiology, Nagoya Heart Center.
FAU - Yoshioka, Naoki
AU  - Yoshioka N
AD  - Department of Cardiology, Ogaki Municipal Hospital.
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 Medicine, Kyoto University Graduate School of 
      Medicine.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20230802
PL  - Japan
TA  - J Atheroscler Thromb
JT  - Journal of atherosclerosis and thrombosis
JID - 9506298
RN  - 5Q7ZVV76EI (Warfarin)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Humans
MH  - Chronic Limb-Threatening Ischemia
MH  - Warfarin
MH  - Retrospective Studies
MH  - Platelet Aggregation Inhibitors/adverse effects
MH  - *Endovascular Procedures/adverse effects
MH  - *Peripheral Arterial Disease/surgery
MH  - Treatment Outcome
MH  - Ischemia/surgery
MH  - Risk Factors
MH  - Lower Extremity/blood supply
MH  - Limb Salvage
MH  - Arteries
MH  - *Heart Failure/etiology
MH  - Chronic Disease
PMC - PMC10776334
OTO - NOTNLM
OT  - Bleeding
OT  - Chronic limb-threatening ischemia
OT  - Endovascular therapy
OT  - High bleeding risk
OT  - Lower-extremity artery disease
COIS- The authors declare no potential conflicts of interest with respect to the 
      research, authorship, and/or publication of this article.
EDAT- 2023/08/03 01:06
MHDA- 2024/01/05 06:43
PMCR- 2024/01/01
CRDT- 2023/08/02 21:38
PHST- 2024/01/05 06:43 [medline]
PHST- 2023/08/03 01:06 [pubmed]
PHST- 2023/08/02 21:38 [entrez]
PHST- 2024/01/01 00:00 [pmc-release]
AID - DN/JST.JSTAGE/jat/64242 [pii]
AID - 10.5551/jat.64242 [doi]
PST - ppublish
SO  - J Atheroscler Thromb. 2024 Jan 1;31(1):100-108. doi: 10.5551/jat.64242. Epub 2023 
      Aug 2.