title: The influence of peripheral arterial disease on outcomes: a pooled analysis of mortality in eight large randomized percutaneous coronary intervention trials.
abstract: OBJECTIVE
  We aimed to evaluate clinical outcomes among peripheral arterial disease (PAD) patients following percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  A significant proportion of patients with coronary artery disease undergoing PCI have concomitant PAD, which may be associated with worse outcomes.
  
  
  METHODS
  We performed a pooled analysis of 8 randomized PCI trials. We included multicenter PCI trials that compared antiplatelet therapies (EPIC, EPILOG, EPISTENT, RAPPORT, CAPTURE, IMPACT-II, TARGET, and CREDO) and had baseline PAD status recorded. Multivariable analyses were performed with stepwise logistic regression for 7- and 30-day outcomes and Cox regression for 6-month and 1-year events.
  
  
  RESULTS
  In our pooled analysis of 19,867 patients undergoing PCI, 1,602 (8.1%) were previously diagnosed with PAD. Patients with PAD had higher incidences of 7-day death (1.0% vs. 0.4%; p < 0.001) or myocardial infarction (MI) (6.8% vs. 5.6%; p = 0.047), 30-day death (1.7% vs. 0.7%; p < 0.001) or MI (7.4% vs. 6.1%; p = 0.05), 6-month death (4.2% vs. 1.5%; p < 0.001) or MI (9.1%, vs. 7.7%; p = 0.048), and 1-year death (5.0% vs. 2.1%; p < 0.001). There was a trend toward higher major bleeding risk with PAD (4.8% vs. 3.9%; p = 0.06). With multivariable analyses, PAD remains a significant predictor of mortality at 30 days (hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.03 to 2.70; p = 0.039), 6 months (HR 1.76, 95% CI 1.31 to 2.37; p < 0.001), and 1 year (HR 1.46, 95% CI 1.08 to 1.96; p = 0.013).
  
  
  CONCLUSIONS
  The presence of PAD is associated with higher rates of post-PCI death and MI, and is an independent predictor of short- and long-term mortality.
authors.affiliation: Department of Medicine, Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Saw
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.forename: David J
authors.initials: DJ
authors.lastname: Moliterno
authors.forename: Sorin J
authors.initials: SJ
authors.lastname: Brener
authors.forename: Steven R
authors.initials: SR
authors.lastname: Steinhubl
authors.forename: A Michael
authors.initials: AM
authors.lastname: Lincoff
authors.forename: James E
authors.initials: JE
authors.lastname: Tcheng
authors.forename: Robert A
authors.initials: RA
authors.lastname: Harrington
authors.forename: Maarten
authors.initials: M
authors.lastname: Simoons
authors.forename: TingFei
authors.initials: T
authors.lastname: Hu
authors.forename: Mobeen A
authors.initials: MA
authors.lastname: Sheikh
authors.forename: Dean J
authors.initials: DJ
authors.lastname: Kereiakes
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Topol
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D001158:Arteries; D003327:Coronary Disease / Q000150:complications* / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D016491:Peripheral Vascular Diseases / Q000150:complications*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D016032:Randomized Controlled Trials as Topic
chemical_list: D019039:Platelet Glycoprotein GPIIb-IIIa Complex