Abstract：
OBJECTIVE: Previous studies in percutaneous coronary intervention (PCI) patients showed a higher 3-year adverse event risk, including all-cause mortality, in those with concomitant peripheral arterial disease (PADs). Ten-year data of mortality and causes of death are scarce. This analysis assessed PCI patients, treated with contemporary drug-eluting stents, the impact of concomitant PADs on very long-term mortality, and causes of death.
METHODS: We assessed PCI all-comers from our center who participated in the TWENTE and DUTCH PEERS trials (clinicaltrials.gov:NCT01066650, NCT01331707), comparing patients with versus without PADs. Life status was checked in the Dutch Personal Records Database; causes of death were obtained from medical records.
RESULTS: Of 2705 study patients, 668 (24.7%) died during follow-up: 88/212 (41.5%) patients with PADs and 580/2493 (23.1%) without PADs. In PADs patients, the 10-year rate of all-cause mortality was about twice as high as in patients without PADs (41.5% vs.23.1%, HR: 2.05, 95%-CI: 1.64-2.57, p<0.001). For both groups, the rates of patients dying from various causes of death were: cardiac (14.1% vs.6.8%), vascular (2.8% vs. 1.1%), non-cardiovascular (17.4% vs. 9.8%), and unclear causes (7.1% vs. 5.3%), without a statistically significant between-group difference. When multivariate analysis was adjusted for between-group differences in cardiovascular risk profile, PADs remained predictor of all-cause mortality (adjusted HR: 1.38, 95%-CI: 1.08-1.75, p=0.01).
CONCLUSIONS: The 10-year all-cause mortality rate in PCI patients with concomitant PADs was almost twice as high as in those without PADs. Age and other traditional cardiovascular risk factors were higher in patients with PADs, but after correction for these confounders PADs still accounted for almost 40% increase in mortality.
METHODS: We assessed PCI all-comers from our center who participated in the TWENTE and DUTCH PEERS trials (clinicaltrials.gov:NCT01066650, NCT01331707), comparing patients with versus without PADs. Life status was checked in the Dutch Personal Records Database; causes of death were obtained from medical records.
RESULTS: Of 2705 study patients, 668 (24.7%) died during follow-up: 88/212 (41.5%) patients with PADs and 580/2493 (23.1%) without PADs. In PADs patients, the 10-year rate of all-cause mortality was about twice as high as in patients without PADs (41.5% vs.23.1%, HR: 2.05, 95%-CI: 1.64-2.57, p<0.001). For both groups, the rates of patients dying from various causes of death were: cardiac (14.1% vs.6.8%), vascular (2.8% vs. 1.1%), non-cardiovascular (17.4% vs. 9.8%), and unclear causes (7.1% vs. 5.3%), without a statistically significant between-group difference. When multivariate analysis was adjusted for between-group differences in cardiovascular risk profile, PADs remained predictor of all-cause mortality (adjusted HR: 1.38, 95%-CI: 1.08-1.75, p=0.01).
CONCLUSIONS: The 10-year all-cause mortality rate in PCI patients with concomitant PADs was almost twice as high as in those without PADs. Age and other traditional cardiovascular risk factors were higher in patients with PADs, but after correction for these confounders PADs still accounted for almost 40% increase in mortality.
摘要：
目的：先前经皮冠状动脉介入治疗（PCI）患者的研究显示3年不良事件风险较高，包括全因死亡率,在伴有外周动脉疾病（PAD）的患者中。死亡率和死亡原因的十年数据很少。这项分析评估了PCI患者，用当代药物洗脱支架治疗，伴随的PAD对长期死亡率的影响，和死亡原因。
方法：我们评估了参加TWENTE和DUTCHPEERS试验（clinicaltrials.gov：NCT01066650，NCT01331707）的来自我们中心的PCI所有参与者，比较有和没有PAD的患者。在荷兰个人记录数据库中检查了生命状况；死亡原因来自医疗记录。
结果：在2705名研究患者中，668例（24.7%）在随访期间死亡：88/212例（41.5%）患者有PAD，580/2493例（23.1%）无PAD。在PAD患者中，10年全因死亡率约为无PAD患者的两倍(41.5%vs.23.1%,HR：2.05，95%-CI：1.64-2.57，p<0.001）。对于这两个群体来说，死于各种死亡原因的患者比率为:心脏病(14.1%vs.8%),血管（2.8%与1.1%)，非心血管疾病（17.4%vs.9.8%），原因不明(7.1%与5.3%），组间差异无统计学意义。当多变量分析调整心血管风险特征的组间差异时，PAD仍然是全因死亡率的预测因子(调整后的HR:1.38,95%-CI:1.08-1.75,p=0.01)。
结论：合并PAD的PCI患者的10年全因死亡率几乎是没有PAD的患者的两倍。PAD患者的年龄和其他传统心血管危险因素较高，但校正这些混杂因素后,PAD仍导致死亡率增加近40%.
方法：我们评估了参加TWENTE和DUTCHPEERS试验（clinicaltrials.gov：NCT01066650，NCT01331707）的来自我们中心的PCI所有参与者，比较有和没有PAD的患者。在荷兰个人记录数据库中检查了生命状况；死亡原因来自医疗记录。
结果：在2705名研究患者中，668例（24.7%）在随访期间死亡：88/212例（41.5%）患者有PAD，580/2493例（23.1%）无PAD。在PAD患者中，10年全因死亡率约为无PAD患者的两倍(41.5%vs.23.1%,HR：2.05，95%-CI：1.64-2.57，p<0.001）。对于这两个群体来说，死于各种死亡原因的患者比率为:心脏病(14.1%vs.8%),血管（2.8%与1.1%)，非心血管疾病（17.4%vs.9.8%），原因不明(7.1%与5.3%），组间差异无统计学意义。当多变量分析调整心血管风险特征的组间差异时，PAD仍然是全因死亡率的预测因子(调整后的HR:1.38,95%-CI:1.08-1.75,p=0.01)。
结论：合并PAD的PCI患者的10年全因死亡率几乎是没有PAD的患者的两倍。PAD患者的年龄和其他传统心血管危险因素较高，但校正这些混杂因素后,PAD仍导致死亡率增加近40%.
