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. 2022 Apr 4:9:853583.
doi: 10.3389/fcvm.2022.853583. eCollection 2022.

Novel Insight Into Long-Term Risk of Major Adverse Cardiovascular and Cerebrovascular Events Following Lower Extremity Arteriosclerosis Obliterans

Ji Sun  1 , Qiang Deng  1 , Jun Wang  1 , Shoupeng Duan  1 , Huaqiang Chen  1 , Huixin Zhou  1 , Zhen Zhou  1 , Fu Yu  1 , Fuding Guo  1 , Chengzhe Liu  1 , Saiting Xu  1 , Lingpeng Song  1 , Yijun Wang  1 , Hui Feng  2 , Lilei Yu  1
Affiliations

Novel Insight Into Long-Term Risk of Major Adverse Cardiovascular and Cerebrovascular Events Following Lower Extremity Arteriosclerosis Obliterans

Ji Sun et al. Front Cardiovasc Med. .

Abstract

Background: Patients with lower extremity arteriosclerosis obliterans (LEASO) are more likely to appear to be associated with adverse cardiovascular outcomes. Currently, few studies have reported the sex-specific characteristics and risk of major cardiovascular and cerebrovascular adverse events (MACCEs) in LEASO. Our study was conducted to determine the characteristics and contributions of LEASO to MACCEs in males and females.

Methods: We conducted a single-center retrospective study of consecutively enrolled patients with first-diagnosed LEASO at Renmin Hospital of Wuhan University from November 2017 to November 2019. The ratio of patients between the LEASO and control groups was 1 to 1 and based on age, sex, comorbid diabetes mellitus and hypertension, current smoking and medications. The occurrence of MACCEs was used as the primary endpoint of this observational study.

Results: A LEASO group (n = 430) and control group (n = 430) were enrolled in this study. A total of 183 patients experienced MACCEs during an average of 38.83 ± 14.28 months of follow-up. Multivariate Cox regression analysis indicated that LEASO was an independent predictor of the occurrence of MACCEs in all patients (HR: 2.448, 95% CI: 1.730-3.464, P < 0.001). Subgroup analysis by sex subgroup was conducted for sex, and LEASO was also an independent predictor of the occurrence of MACCEs in both male cases (HR: 2.919, 95% CI: 1.776-4.797, P < 0.001) and female cases (HR: 1.788, 95% CI: 1.110-2.880, P = 0.017). Moreover, Kaplan-Meier analysis indicated no significant difference in event-free survival between patients of different sexes with LEASO (χ2 = 0.742, P = 0.389).

Conclusion: LEASO tended to a useful risk stratified indicator for MACCEs in both male and female patients in our study. Notably, attention should be given to patients with LEASO who should undergo comprehensive cardiovascular evaluation and intervention, even if there is a lack of traditional cardiovascular risk factors.

Keywords: coronary artery disease; gender; lower extremity arteriosclerosis obliterans; major cardiovascular and cerebrovascular adverse events; panvascular disease.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Major adverse cardiovascular and cerebrovascular events (MACCEs)-free survival rates for patients with LEASO group and control group during the follow-up period.
FIGURE 2
FIGURE 2
Receiver operating character analysis for the predictive efficacy of variables for MACCEs (Model 1, Gender + Age + Hypertension + Diabetes + current smoking + current drinking; Model 2, Model 1 + LEASO).
FIGURE 3
FIGURE 3
Major adverse cardiovascular and cerebrovascular events-free survival rates for male patients with LEASO group and control group during the follow-up period.
FIGURE 4
FIGURE 4
Major adverse cardiovascular and cerebrovascular events-free survival rates for female patients with LEASO group and control group during the follow-up period.
FIGURE 5
FIGURE 5
Major adverse cardiovascular and cerebrovascular events-free survival rates for male and female patients with LEASO during the follow-up period.
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