AI Article Synopsis
- Critical limb ischemia (CLI) patients with concomitant coronary artery disease (CAD) face a high risk of cerebrovascular and cardiovascular death, especially within two years post-revascularization.
- This study revealed that malnutrition, indicated by a lower geriatric nutritional risk index (GNRI), and the need for hemodialysis (HD) are significant risk factors linked to increased mortality in these patients.
- The findings suggest that improving nutritional status and utilizing clopidogrel are critical strategies to reduce the risk of death in CLI patients with CAD.
Article Abstract
Critical limb ischemia (CLI) patients have high risk for major adverse cerebrovascular and cardiovascular events. This study investigated the risk factors of cerebrovascular or cardiovascular death in CLI patients with concomitant coronary artery disease (CAD). The association between baseline characteristics and cerebrovascular or cardiovascular death ≤2 years after revascularization for CLI was investigated in 137 CLI patients who previously underwent successful revascularization for CAD before treatment for CLI. Twenty-three patients (17%) died. Geriatric nutritional risk index (GNRI) in the deceased group (DG) was significantly lower than in the surviving group (SG). On Cox proportional hazard multivariate analysis, hemodialysis (HD) and malnutrition (defined as GNRI <92) were significantly associated with cerebrovascular or cardiovascular death. Also, on Kaplan-Meier analysis, survival rate was significantly lower in CLI patients with either malnutrition or HD compared with patients without either malnutrition or HD, respectively. Furthermore, clopidogrel was less used in the DG than in the SG. The use of clopidogrel was associated with cerebrovascular or cardiovascular death. Especially, non-use of clopidogrel in the malnutrition group further increased the correlation with cerebrovascular or cardiovascular death. Malnutrition is a crucial risk factor for cerebrovascular and cardiovascular death in CLI patients with CAD. Nutritional status intervention and use of clopidogrel may be an important strategy for CLI.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929756 | PMC |
| http://dx.doi.org/10.1253/circrep.CR-19-0105 | DOI Listing |
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