PDF(Pubmed)
Abstract：
Coronary artery disease (CAD) is often noted in patients with lower-extremity artery disease (LEAD). However, the effects of CAD on patients with LEAD have not been clearly investigated. In this study, to investigate the effect of CAD on patients with LEAD without chronic limb-threatening ischemia (CLTI), we compared the five-year clinical outcomes of patients with and without CAD. Between 2014 and 2017, 246 patients with symptomatic LEAD without CLTI underwent endovascular treatment. Patients with a history of CAD revascularization or CAD defined by CAD studies were divided into CAD groups, and others were non-CAD groups. After excluding ineligible patients, propensity matching produced 40 patients in each group, and clinical outcomes were compared between the groups. Using five years of Kaplan-Meier analysis between the CAD and non-CAD groups, no significant differences were observed in survival (90.0% vs 92.5%, p=0.693), freedom from cardiovascular events (42.5% vs 57.5%, p=0.110), freedom from LEAD revascularization (67.5% vs 67.5%, p=0.940), and freedom from CLTI (100% vs. 95.0%, p=0.148). However, significant differences were observed in freedom from CAD revascularization (67.5% vs 97.5%, p<0.001) and freedom from symptomatic CAD (85.0% vs 97.5%, p=0.048). Our results suggest that in patients with LEAD without CLTI, CAD caused increased CAD revascularization and symptomatic CAD. However, CAD did not affect survival, cardiovascular events, LEAD revascularization, or CLTI in such patients. When CAD was observed in patients with LEAD without CLTI, more frequent follow-up of CAD may improve the long-term clinical outcomes of such patients.
摘要：
冠状动脉疾病（CAD）通常在下肢动脉疾病（LEAD）患者中出现。然而,CAD对LEAD患者的影响尚未明确研究.在这项研究中,研究CAD对无慢性威胁肢体缺血（CLTI）的LEAD患者的影响，我们比较了有和无CAD患者的5年临床结局.在2014年至2017年期间，246例无CLTI的症状性LEAD患者接受了血管内治疗。有CAD血运重建或CAD研究定义的CAD病史的患者被分为CAD组。其他人是非CAD组。排除不合格患者后，倾向匹配产生了每组40名患者，并比较两组间的临床结局.使用CAD和非CAD组之间的五年Kaplan-Meier分析，生存率无显著差异(90.0%vs92.5%，p=0.693),无心血管事件（42.5%vs57.5%，p=0.110)，无LEAD血运重建(67.5%vs67.5%，p=0.940),和不受CLTI的影响(100%vs.95.0%,p=0.148）。然而,在无CAD血运重建方面观察到显著差异(67.5%vs97.5%,p<0.001）和无症状性CAD（85.0％vs97.5％，p=0.048)。我们的结果表明，在没有CLTI的LEAD患者中，CAD导致CAD血运重建和症状性CAD增加。然而,CAD没有影响生存，心血管事件,导致血运重建，或CLTI在这样的患者。当在没有CLTI的LEAD患者中观察到CAD时，更频繁的CAD随访可能改善此类患者的长期临床结局.
