Association of lower extremity arterial calcification with amputation and mortality in patients with symptomatic peripheral artery disease
Journal
PLoS ONE
Journal Volume
9
Journal Issue
2
Date Issued
2014
Author(s)
Abstract
Objective: The clinical implication of the coronary artery calcium score (CS) is well demonstrated. However, little is known about the association between lower extremity arterial calcification and clinical outcomes. Methods and Results: Eighty-two patients with symptomatic peripheral artery disease (age 61.0±12.4 years) were followed for 21±11 months. CSs, ranging from the common iliac artery bifurcation to the ankle area, were analyzed through noncontrast multidetector computed tomography images retrospectively. The primary endpoints of this study were amputation and mortality. Old age, diabetes, hyperlipidemia, and end-stage renal disease were associated with higher CSs. Patients with more advanced Fontaine stages also tended to have significantly higher CSs (p = 0.03). During the follow-up period (21±11 months), 29 (35%) patients underwent amputation, and 24 (29%) patients died. Among the patients who underwent amputation, there were no significant differences in CSs between the amputated legs and the non-amputated legs. In the Cox proportional hazard model with CS divided into quartiles, patients with CS in the highest quartile had a 2.88-fold (95% confidence interval [CI] 1.18-12.72, p= 0.03) and a 5.16-fold (95% CI 1.13-21.61, p = 0.04) higher risk for amputation and all-cause mortality, respectively, than those with CS in the lowest quartile. These predictive effects remained after conventional risk factor adjustment. Conclusion: Lower extremity arterial CSs are associated with disease severity and outcomes, including amputation and all-cause mortality, in patients with symptomatic peripheral artery disease. However, the independent predictive value needs further investigation in large scale, prospective studies. ? 2014 Huang et al.
SDGs
Other Subjects
adult; aged; artery calcification; article; cardiovascular risk; controlled study; diabetes mellitus; disease association; end stage renal disease; female; follow up; high risk patient; human; hyperlipidemia; iliac artery; leg amputation; leg artery; major clinical study; male; middle aged; mortality; multidetector computed tomography; observational study; peripheral occlusive artery disease; prediction; retrospective study; risk assessment; senescence; symptom; Aged; Amputation; Arteries; Calcinosis; Calcium; Female; Humans; Lower Extremity; Male; Peripheral Arterial Disease; Risk Factors
Publisher
Public Library of Science
Type
journal article