title: Diabetes and Critical Limb Ischemia: The Deadly Duo in Patients with Symptomatic Peripheral Artery Disease.
abstract: Inflammation plays an important role in the initiation and progression of peripheral artery disease (PAD). Patients with diabetes have an increased risk of developing PAD. Data regarding the prognostic implication of diabetes and inflammation on all-cause mortality in patients with symptomatic PAD and preserved left ventricular ejection fraction (LVEF >50%). The study was conducted at the Sestre milosrdnice University Hospital Center between January 2010 and January 2014 on 319 consecutive patients with symptomatic PAD and preserved LVEF (66.5% men, mean age 70±10 years, ankle brachial index 0.58±0.14). Thirty-eight (12%) patients died during median follow up period of 24 months (interquartile range, 16-34 months). On univariate analysis, C-reactive protein was significantly associated with all-cause mortality (HR 2.21, 95% CI 1.09-4.48). After multivariate regression analysis, age (HR 1.07, 95% CI 1.02-1.11), diabetes (HR 2.24, 95% CI 1.04-4.82), and critical limb ischemia (HR 2.22, 95% CI 1.03-4.80) remained the only independent predictors for all-cause mortality. Diabetes and critical limb ischemia are independently associated with an increased risk of mortality in symptomatic PAD patients with preserved LVEF.
authors.affiliation: Department of Vascular Medicine, Cardiovascular Center, Sestre milosrdnice University Hospital Center, Zagreb, Croatia|School of Medicine, University of Zagreb, Zagreb, Croatia
authors.forename: Mislav
authors.lastname: Vrsalović
authors.affiliation: Institute of Emergency Medicine of the Zagreb County, Zagreb, Croatia
authors.forename: Ksenija
authors.lastname: Vučur
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D003925:Diabetic Angiopathies / Q000097:blood / Q000150:complications* / Q000401:mortality*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000150:complications* / Q000401:mortality*; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000097:blood / Q000150:complications* / Q000401:mortality*; D013318:Stroke Volume; D015996:Survival Rate
chemical_list: D002097:C-Reactive Protein
keywords: Diabetes mellitus; Extremities – blood supply; Ischemia; Inflammation; C-reactive protein; Mortality; Peripheral arterial disease