Diabetes mellitus and other cardiovascular risk factors in lower-extremity peripheral artery disease versus coronary artery disease: an analysis of 1,121,359 cases from the nationwide databases
Abstract Background Lower-extremity peripheral artery disease (LE-PAD) and coronary artery disease (CAD) are both pathologically rooted in atherosclerosis, and their shared clinical features regarding the exposure to cardiovascular risk factors have been emphasized. However, comparative data of the...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12933-019-0955-5 |
| _version_ | 1818187985834737664 |
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| author | Mitsuyoshi Takahara Osamu Iida Shun Kohsaka Yoshimitsu Soga Masahiko Fujihara Toshiro Shinke Tetsuya Amano Yuji Ikari the J-EVT and J-PCI investigators |
| author_facet | Mitsuyoshi Takahara Osamu Iida Shun Kohsaka Yoshimitsu Soga Masahiko Fujihara Toshiro Shinke Tetsuya Amano Yuji Ikari the J-EVT and J-PCI investigators |
| author_sort | Mitsuyoshi Takahara |
| collection | DOAJ |
| description | Abstract Background Lower-extremity peripheral artery disease (LE-PAD) and coronary artery disease (CAD) are both pathologically rooted in atherosclerosis, and their shared clinical features regarding the exposure to cardiovascular risk factors have been emphasized. However, comparative data of the two cardiovascular diseases (CVDs) were so far lacking. The purpose of this study was to directly compare the clinical profile between cases undergoing endovascular therapy (EVT) for LE-PAD and those undergoing percutaneous coronary intervention (PCI). Methods Data were extracted from the nationwide procedural databases of EVT and PCI in Japan (J-EVT and J-PCI) between 2012 and 2017. A total of 1,121,359 cases (103,887 EVT cases for critical limb ischemia [CLI] or intermittent claudication and 1,017,472 PCI cases for acute coronary syndrome [ACS] or stable angina) were analyzed. Heterogeneity in clinical profile between CVDs was evaluated using the C statistic of the logistic regression model for which dependent variable was one CVD versus another, and explanatory variables were clinical profile. When two CVDs were completely discriminated from each other by the developed model, the C statistic (discrimination ability) of the model would be equal to 1, indicating that the two CVDs were completely different in clinical profile. On the other hand, when two CVDs were identical in clinical profile, the developed model would not discriminate them at all, with the C statistic equal to 0.5. Results Mean age was 73.5 ± 9.3 years in LE-PAD patients versus 70.0 ± 11.2 years in CAD patients (P < 0.001). The prevalence of diabetes mellitus and end-stage renal disease was 1.96- and 6.39-times higher in LE-PAD patients than in CAD patients (both P < 0.001). The higher prevalence was observed irrespective of age group. The exposure to other cardiovascular risk factors and the likelihood of cardiovascular risk clustering also varied between the diseases. The between-disease heterogeneity in patient profile was particularly evident between CLI and ACS, with the C statistic equal to 0.833 (95% CI 0.831–0.836). Conclusions The current study, an analysis based on nationwide procedural databases, confirmed that patient profiles were not identical but rather considerably different between clinically significant LE-PAD and CAD warranting revascularization. |
| first_indexed | 2024-12-11T23:19:44Z |
| format | Article |
| id | doaj.art-f3aac213a4d04a048cf993126642022a |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-11T23:19:44Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-f3aac213a4d04a048cf993126642022a2022-12-22T00:46:23ZengBMCCardiovascular Diabetology1475-28402019-11-011811910.1186/s12933-019-0955-5Diabetes mellitus and other cardiovascular risk factors in lower-extremity peripheral artery disease versus coronary artery disease: an analysis of 1,121,359 cases from the nationwide databasesMitsuyoshi Takahara0Osamu Iida1Shun Kohsaka2Yoshimitsu Soga3Masahiko Fujihara4Toshiro Shinke5Tetsuya Amano6Yuji Ikari7the J-EVT and J-PCI investigatorsThe Japanese Association of Cardiovascular Intervention and TherapeuticsThe Japanese Association of Cardiovascular Intervention and TherapeuticsThe Japanese Association of Cardiovascular Intervention and TherapeuticsThe Japanese Association of Cardiovascular Intervention and TherapeuticsThe Japanese Association of Cardiovascular Intervention and TherapeuticsThe Japanese Association of Cardiovascular Intervention and TherapeuticsThe Japanese Association of Cardiovascular Intervention and TherapeuticsThe Japanese Association of Cardiovascular Intervention and TherapeuticsAbstract Background Lower-extremity peripheral artery disease (LE-PAD) and coronary artery disease (CAD) are both pathologically rooted in atherosclerosis, and their shared clinical features regarding the exposure to cardiovascular risk factors have been emphasized. However, comparative data of the two cardiovascular diseases (CVDs) were so far lacking. The purpose of this study was to directly compare the clinical profile between cases undergoing endovascular therapy (EVT) for LE-PAD and those undergoing percutaneous coronary intervention (PCI). Methods Data were extracted from the nationwide procedural databases of EVT and PCI in Japan (J-EVT and J-PCI) between 2012 and 2017. A total of 1,121,359 cases (103,887 EVT cases for critical limb ischemia [CLI] or intermittent claudication and 1,017,472 PCI cases for acute coronary syndrome [ACS] or stable angina) were analyzed. Heterogeneity in clinical profile between CVDs was evaluated using the C statistic of the logistic regression model for which dependent variable was one CVD versus another, and explanatory variables were clinical profile. When two CVDs were completely discriminated from each other by the developed model, the C statistic (discrimination ability) of the model would be equal to 1, indicating that the two CVDs were completely different in clinical profile. On the other hand, when two CVDs were identical in clinical profile, the developed model would not discriminate them at all, with the C statistic equal to 0.5. Results Mean age was 73.5 ± 9.3 years in LE-PAD patients versus 70.0 ± 11.2 years in CAD patients (P < 0.001). The prevalence of diabetes mellitus and end-stage renal disease was 1.96- and 6.39-times higher in LE-PAD patients than in CAD patients (both P < 0.001). The higher prevalence was observed irrespective of age group. The exposure to other cardiovascular risk factors and the likelihood of cardiovascular risk clustering also varied between the diseases. The between-disease heterogeneity in patient profile was particularly evident between CLI and ACS, with the C statistic equal to 0.833 (95% CI 0.831–0.836). Conclusions The current study, an analysis based on nationwide procedural databases, confirmed that patient profiles were not identical but rather considerably different between clinically significant LE-PAD and CAD warranting revascularization.http://link.springer.com/article/10.1186/s12933-019-0955-5Cardiovascular risk factorsPeripheral artery diseaseCoronary artery disease |
| spellingShingle | Mitsuyoshi Takahara Osamu Iida Shun Kohsaka Yoshimitsu Soga Masahiko Fujihara Toshiro Shinke Tetsuya Amano Yuji Ikari the J-EVT and J-PCI investigators Diabetes mellitus and other cardiovascular risk factors in lower-extremity peripheral artery disease versus coronary artery disease: an analysis of 1,121,359 cases from the nationwide databases Cardiovascular Diabetology Cardiovascular risk factors Peripheral artery disease Coronary artery disease |
| title | Diabetes mellitus and other cardiovascular risk factors in lower-extremity peripheral artery disease versus coronary artery disease: an analysis of 1,121,359 cases from the nationwide databases |
| title_full | Diabetes mellitus and other cardiovascular risk factors in lower-extremity peripheral artery disease versus coronary artery disease: an analysis of 1,121,359 cases from the nationwide databases |
| title_fullStr | Diabetes mellitus and other cardiovascular risk factors in lower-extremity peripheral artery disease versus coronary artery disease: an analysis of 1,121,359 cases from the nationwide databases |
| title_full_unstemmed | Diabetes mellitus and other cardiovascular risk factors in lower-extremity peripheral artery disease versus coronary artery disease: an analysis of 1,121,359 cases from the nationwide databases |
| title_short | Diabetes mellitus and other cardiovascular risk factors in lower-extremity peripheral artery disease versus coronary artery disease: an analysis of 1,121,359 cases from the nationwide databases |
| title_sort | diabetes mellitus and other cardiovascular risk factors in lower extremity peripheral artery disease versus coronary artery disease an analysis of 1 121 359 cases from the nationwide databases |
| topic | Cardiovascular risk factors Peripheral artery disease Coronary artery disease |
| url | http://link.springer.com/article/10.1186/s12933-019-0955-5 |
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