PMID- 37984325
OWN - NLM
STAT- MEDLINE
DCOM- 20231122
LR  - 20231122
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 35
IP  - 10
DP  - 2023 Oct
TI  - Temporal trends and outcomes of patients with chronic limb-threatening ischemia 
      with and without history of coronary artery disease: insights from the us 
      national inpatient sample database.
LID - 10.25270/jic/23.00191 [doi]
AB  - BACKGROUND: The burden and prognostic significance of coronary artery disease 
      (CAD) in adults with peripheral artery disease and chronic limb-threatening 
      ischemia (CLTI) is unknown. METHODS: Temporal trends in prevalence of significant 
      CAD (history of myocardial infarction or coronary revascularizations) in 
      hospitalizations for CLTI were determined using the 2000 to 2018 National 
      Inpatient Sample (NIS) database. A multivariable regression analysis of outcomes 
      was performed based on presence or absence of CAD. RESULTS: Among 13 575 099 
      hospitalizations for CLTI (41% female, 69% white, mean age 69 years), 23% had 
      concomitant CAD, of which 11% underwent lower extremity arterial 
      revascularization (43.6% endovascular and 56.4% surgical). The prevalence of 
      concomitant CAD with CLTI increased from 15.3% in 2000 to 23.1% in 2018. 
      Furthermore, the frequency of endovascular revascularization in adults with CAD 
      and CLTI increased from 15.1% to 48.3%, while there was a decreasing trend of 
      surgical revascularization, from 84.9% to 51.7%. After multivariate adjustments, 
      CLTI with CAD was associated with increased risk of in-hospital mortality (OR, 
      1.40; 95% CI, 1.32-1.47; P less than .0001) and bleeding requiring transfusion 
      (OR, 1.10; 95% CI, 1.06-1.12; P less than .0001) compared with patients with CLTI 
      without CAD. As compared with surgical revascularization, endovascular 
      revascularization was associated with lower risk of in-hospital mortality in both 
      patients with CLTI with CAD (OR, 0.69; 95% CI, 0.63-0.76; P less than .001) and 
      CLTI without CAD (OR, 0.71; 95% CI, 0.67-0.76; P less than .001). CONCLUSIONS: 
      Prevalence of CAD has increased in adults presenting with CLTI and is associated 
      with poor outcomes, warranting the need for effective interventions and secondary 
      prevention in this high-risk population.
FAU - Chunawala, Zainali S
AU  - Chunawala ZS
AD  - Department of Medicine, University of Texas Southwestern Medical Center, Dallas, 
      TX, USA.
FAU - Chew, Christopher
AU  - Chew C
AD  - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Hendrickson, Michael
AU  - Hendrickson M
AD  - Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 
      Boston, MA, USA.
FAU - Arora, Sameer
AU  - Arora S
AD  - Division of Cardiology, University of North Carolina School of Medicine, Chapel 
      Hill, NC, USA; Wellstar Cardiovascular Medicine, Marietta, GA, USA.
FAU - Tafur, Alfonso
AU  - Tafur A
AD  - Section of Interventional Cardiology and Vascular Medicine, Division of 
      Cardiology, NorthShore University Health System, Evanston, IL, USA.
FAU - Mishkel, Gregory
AU  - Mishkel G
AD  - Section of Interventional Cardiology and Vascular Medicine, Division of 
      Cardiology, NorthShore University Health System, Evanston, IL, USA.
FAU - Ricciardi, Mark J
AU  - Ricciardi MJ
AD  - Section of Interventional Cardiology and Vascular Medicine, Division of 
      Cardiology, NorthShore University Health System, Evanston, IL, USA.
FAU - Zelniker, Thomas A
AU  - Zelniker TA
AD  - Division of Medicine II, Division of Cardiology, Medical University of Vienna, 
      Vienna, Austria.
FAU - Moussa, Issam D
AU  - Moussa ID
AD  - Heart and Vascular Institute, University of Illinois at Urbana-Champaign, IL, 
      USA.
FAU - Hassan, Atif
AU  - Hassan A
AD  - Section of Interventional Cardiology and Vascular Medicine, Division of 
      Cardiology, NorthShore University Health System, Evanston, IL, USA.
FAU - Golzar, Jaafer
AU  - Golzar J
AD  - Division of Cardiology, Advocate Christ Medical Center, Chicago, IL, USA.
FAU - Gueyikian, Sebouh
AU  - Gueyikian S
AD  - Division of Interventional Radiology, NorthShore University Health System, 
      Evanston, IL, USA.
FAU - Bechara, Carlos F
AU  - Bechara CF
AD  - Department of Vascular Surgery, Loyola University Medical Center, Maywood, IL, 
      USA.
FAU - Lee, Cheong Jun
AU  - Lee CJ
AD  - Department of Vascular Surgery, NorthShore University Health System, Evanston, 
      IL, USA.
FAU - Qamar, Arman
AU  - Qamar A
AD  - Section of Interventional Cardiology and Vascular Medicine, Division of 
      Cardiology, NorthShore University Health System, Evanston, IL, USA. Email: 
      aqamar@alumni.harvard.edu.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
SB  - IM
MH  - Humans
MH  - Female
MH  - Aged
MH  - Male
MH  - Chronic Limb-Threatening Ischemia
MH  - *Coronary Artery Disease/complications/diagnosis/epidemiology
MH  - Inpatients
MH  - *Endovascular Procedures/adverse effects
MH  - Limb Salvage
MH  - Treatment Outcome
MH  - Ischemia/diagnosis/epidemiology/etiology
MH  - Chronic Disease
MH  - Risk Factors
MH  - *Peripheral Arterial Disease/complications/diagnosis/epidemiology
MH  - Retrospective Studies
OTO - NOTNLM
OT  - National Inpatient Sample
OT  - chronic limb-threatening ischemia
OT  - coronary artery disease
EDAT- 2023/11/21 01:07
MHDA- 2023/11/22 06:43
CRDT- 2023/11/20 18:18
PHST- 2023/11/22 06:43 [medline]
PHST- 2023/11/21 01:07 [pubmed]
PHST- 2023/11/20 18:18 [entrez]
AID - 10.25270/jic/23.00191 [doi]
PST - ppublish
SO  - J Invasive Cardiol. 2023 Oct;35(10). doi: 10.25270/jic/23.00191.