Outcome in octogenarian patients with lower extremity artery disease after endovascular revascularisation: a retrospective single-centre cohort study using in-patient data
Objectives To investigate the clinical benefit of endovascular revascularisation (EVR) in octogenarian (aged ≥80 years) patients with lower extremity artery disease (LEAD).Design Retrospective single-centre study.Setting University hospital with a specialised centre for vascular medicine.Participant...
| Hlavní autoři: | , , , , , , , , , |
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| Médium: | Článek |
| Jazyk: | English |
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BMJ Publishing Group
2022-08-01
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| Edice: | BMJ Open |
| On-line přístup: | https://bmjopen.bmj.com/content/12/8/e057630.full |
| _version_ | 1828359115589550080 |
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| author | Holger Reinecke Christiane Engelbertz Nasser M Malyar Antonia Lakomek Jeanette Köppe Henrike Barenbrock Kristina Volkery Jannik Feld Lena Makowski Eva Freisinger |
| author_facet | Holger Reinecke Christiane Engelbertz Nasser M Malyar Antonia Lakomek Jeanette Köppe Henrike Barenbrock Kristina Volkery Jannik Feld Lena Makowski Eva Freisinger |
| author_sort | Holger Reinecke |
| collection | DOAJ |
| description | Objectives To investigate the clinical benefit of endovascular revascularisation (EVR) in octogenarian (aged ≥80 years) patients with lower extremity artery disease (LEAD).Design Retrospective single-centre study.Setting University hospital with a specialised centre for vascular medicine.Participants 681 LEAD patients undergoing EVR between 2010 and 2016 were stratified by age.Main outcome measure Technical success, complications and mortality.Results The cohort comprised 172 (25.3%) octogenarian and 509 (74.7%) non-octogenarian patients. Despite higher LEAD stages and complexity of EVR in octogenarians, primary technical success rate (79% octogenarians vs 86% non-octogenarians, p=0.006) and 1-year survival (87% vs 96%, p<0.001) were overall on high levels. Especially for the octogenarians, 1-year survival depends on the presence of chronic limb-threatening ischaemia (CLTI) (octogenarians: non-CLTI 98%; CLTI 79% p<0.001 vs non-octogenarians: non-CLTI 99%; CLTI 91%, p<0.001). In octogenarians, female sex (HR 0.45; 95% CI (0.24 to 0.86); p=0.015), the intake of statins (HR 0.34; 95% CI 0.19 to 0.65; p=0.001) and platelet aggregation inhibitors (HR 0.10; 95% CI 0.02 to 0.45; p=0.003) were independently associated with improved survival after EVR.Conclusion EVR can be performed safely and with sustained clinical benefit also in octogenarian patients with LEAD. After-care including medical adherence is of particular importance to improve long-term survival. |
| first_indexed | 2024-04-14T03:38:02Z |
| format | Article |
| id | doaj.art-d6cb15e0b1454b5d9388e946f2d877d5 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-14T03:38:02Z |
| publishDate | 2022-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-d6cb15e0b1454b5d9388e946f2d877d52022-12-22T02:14:41ZengBMJ Publishing GroupBMJ Open2044-60552022-08-0112810.1136/bmjopen-2021-057630Outcome in octogenarian patients with lower extremity artery disease after endovascular revascularisation: a retrospective single-centre cohort study using in-patient dataHolger Reinecke0Christiane Engelbertz1Nasser M Malyar2Antonia Lakomek3Jeanette Köppe4Henrike Barenbrock5Kristina Volkery6Jannik Feld7Lena Makowski8Eva Freisinger93 Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany1 Dept. of Cardiology I - Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol, Muenster, Germanynasser.malyar@medizin.uni-essen.deDepartment of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Muenster, Nordrhein-Westfalen, GermanyInstitute of Biostatistics and Clinical Research, University of Muenster, Muenster, Nordrhein-Westfalen, GermanyDepartment of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Muenster, Nordrhein-Westfalen, GermanyDepartment of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Muenster, Nordrhein-Westfalen, GermanyInstitute of Biostatistics and Clinical Research, University of Muenster, Muenster, Nordrhein-Westfalen, GermanyDepartment of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Muenster, Nordrhein-Westfalen, GermanyDepartment of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Muenster, Nordrhein-Westfalen, GermanyObjectives To investigate the clinical benefit of endovascular revascularisation (EVR) in octogenarian (aged ≥80 years) patients with lower extremity artery disease (LEAD).Design Retrospective single-centre study.Setting University hospital with a specialised centre for vascular medicine.Participants 681 LEAD patients undergoing EVR between 2010 and 2016 were stratified by age.Main outcome measure Technical success, complications and mortality.Results The cohort comprised 172 (25.3%) octogenarian and 509 (74.7%) non-octogenarian patients. Despite higher LEAD stages and complexity of EVR in octogenarians, primary technical success rate (79% octogenarians vs 86% non-octogenarians, p=0.006) and 1-year survival (87% vs 96%, p<0.001) were overall on high levels. Especially for the octogenarians, 1-year survival depends on the presence of chronic limb-threatening ischaemia (CLTI) (octogenarians: non-CLTI 98%; CLTI 79% p<0.001 vs non-octogenarians: non-CLTI 99%; CLTI 91%, p<0.001). In octogenarians, female sex (HR 0.45; 95% CI (0.24 to 0.86); p=0.015), the intake of statins (HR 0.34; 95% CI 0.19 to 0.65; p=0.001) and platelet aggregation inhibitors (HR 0.10; 95% CI 0.02 to 0.45; p=0.003) were independently associated with improved survival after EVR.Conclusion EVR can be performed safely and with sustained clinical benefit also in octogenarian patients with LEAD. After-care including medical adherence is of particular importance to improve long-term survival.https://bmjopen.bmj.com/content/12/8/e057630.full |
| spellingShingle | Holger Reinecke Christiane Engelbertz Nasser M Malyar Antonia Lakomek Jeanette Köppe Henrike Barenbrock Kristina Volkery Jannik Feld Lena Makowski Eva Freisinger Outcome in octogenarian patients with lower extremity artery disease after endovascular revascularisation: a retrospective single-centre cohort study using in-patient data BMJ Open |
| title | Outcome in octogenarian patients with lower extremity artery disease after endovascular revascularisation: a retrospective single-centre cohort study using in-patient data |
| title_full | Outcome in octogenarian patients with lower extremity artery disease after endovascular revascularisation: a retrospective single-centre cohort study using in-patient data |
| title_fullStr | Outcome in octogenarian patients with lower extremity artery disease after endovascular revascularisation: a retrospective single-centre cohort study using in-patient data |
| title_full_unstemmed | Outcome in octogenarian patients with lower extremity artery disease after endovascular revascularisation: a retrospective single-centre cohort study using in-patient data |
| title_short | Outcome in octogenarian patients with lower extremity artery disease after endovascular revascularisation: a retrospective single-centre cohort study using in-patient data |
| title_sort | outcome in octogenarian patients with lower extremity artery disease after endovascular revascularisation a retrospective single centre cohort study using in patient data |
| url | https://bmjopen.bmj.com/content/12/8/e057630.full |
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