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The impact of diabetes mellitus on major amputation among patients with chronic limb threatening ischemia undergoing elective endovascular therapy- a nationwide propensity score adjusted analysis

Lilja, Erika LU ; Gottsäter, Anders LU ; Miftaraj, Mervete ; Ekelund, Jan ; Eliasson, Björn ; Svensson, Ann Marie ; Zarrouk, Moncef LU ; Nilsson, Peter LU and Acosta, Stefan LU (2021) In Journal of Diabetes and its Complications 35(2).
Abstract

Aim: To investigate the risk of major amputation after elective endovascular therapy in patients with chronic limb threatening ischemia (CLTI) comparing patients with and without diabetes mellitus (DM). Methods: In this nationwide cohort study, all patients registered in the Swedish Vascular Register after elective endovascular therapy for CLTI caused by infra-inguinal arterial disease from 2010 to 2014 were included. Among 4578 individuals, 2251 had DM and were registered in the National Diabetes Register between 2009 and 2014. A propensity score adjusted Cox regression analysis was conducted to compare outcomes between groups. Median follow-up was 4.0 and 3.6 years for patients with DM and without DM, respectively. Results: The... (More)

Aim: To investigate the risk of major amputation after elective endovascular therapy in patients with chronic limb threatening ischemia (CLTI) comparing patients with and without diabetes mellitus (DM). Methods: In this nationwide cohort study, all patients registered in the Swedish Vascular Register after elective endovascular therapy for CLTI caused by infra-inguinal arterial disease from 2010 to 2014 were included. Among 4578 individuals, 2251 had DM and were registered in the National Diabetes Register between 2009 and 2014. A propensity score adjusted Cox regression analysis was conducted to compare outcomes between groups. Median follow-up was 4.0 and 3.6 years for patients with DM and without DM, respectively. Results: The incidence rates of major amputation and acute myocardial infarction (AMI) were 43% (95% CI 1.23–1.67) and 37% (95% CI 1.13–1.67) higher, respectively, among patients with DM compared to patients without DM. There was no difference in mortality (HR 1.04, 95% CI 0.95–1.14). Conclusions: Patients with DM had a higher risk of major amputation and AMI compared to those without DM after elective endovascular therapy for CLTI. Prevention of DM with CLTI is of utmost importance to reduce the risk of adverse limb and cardiovascular outcomes.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chronic limb-threatening ischemia, Diabetes mellitus, Endovascular revascularization, Major amputation, Propensity score adjusted analysis
in
Journal of Diabetes and its Complications
volume
35
issue
2
article number
107675
publisher
Elsevier
external identifiers
  • pmid:32828647
  • scopus:85089584825
ISSN
1056-8727
DOI
10.1016/j.jdiacomp.2020.107675
language
English
LU publication?
yes
id
de390431-d644-4e2a-af05-bb5f9f543f0e
date added to LUP
2020-08-28 10:29:09
date last changed
2021-03-31 01:52:13
@article{de390431-d644-4e2a-af05-bb5f9f543f0e,
  abstract     = {<p>Aim: To investigate the risk of major amputation after elective endovascular therapy in patients with chronic limb threatening ischemia (CLTI) comparing patients with and without diabetes mellitus (DM). Methods: In this nationwide cohort study, all patients registered in the Swedish Vascular Register after elective endovascular therapy for CLTI caused by infra-inguinal arterial disease from 2010 to 2014 were included. Among 4578 individuals, 2251 had DM and were registered in the National Diabetes Register between 2009 and 2014. A propensity score adjusted Cox regression analysis was conducted to compare outcomes between groups. Median follow-up was 4.0 and 3.6 years for patients with DM and without DM, respectively. Results: The incidence rates of major amputation and acute myocardial infarction (AMI) were 43% (95% CI 1.23–1.67) and 37% (95% CI 1.13–1.67) higher, respectively, among patients with DM compared to patients without DM. There was no difference in mortality (HR 1.04, 95% CI 0.95–1.14). Conclusions: Patients with DM had a higher risk of major amputation and AMI compared to those without DM after elective endovascular therapy for CLTI. Prevention of DM with CLTI is of utmost importance to reduce the risk of adverse limb and cardiovascular outcomes.</p>},
  author       = {Lilja, Erika and Gottsäter, Anders and Miftaraj, Mervete and Ekelund, Jan and Eliasson, Björn and Svensson, Ann Marie and Zarrouk, Moncef and Nilsson, Peter and Acosta, Stefan},
  issn         = {1056-8727},
  language     = {eng},
  number       = {2},
  publisher    = {Elsevier},
  series       = {Journal of Diabetes and its Complications},
  title        = {The impact of diabetes mellitus on major amputation among patients with chronic limb threatening ischemia undergoing elective endovascular therapy- a nationwide propensity score adjusted analysis},
  url          = {http://dx.doi.org/10.1016/j.jdiacomp.2020.107675},
  doi          = {10.1016/j.jdiacomp.2020.107675},
  volume       = {35},
  year         = {2021},
}