Association between complete revascularization of the coronary artery and clinical outcomes in peripheral artery disease: a sub-analysis of the I-PAD Nagano registry

• Published in: Heart and vessels Vol. 38; no. 8; pp. 1001 - 1008
• Main Authors: Kato, Tamon, Ueki, Yasushi, Minamisawa, Masatoshi, Miura, Takashi, Oyama, Yushi, Hashizume, Naoto, Yokota, Daisuke, Taki, Minami, Senda, Keisuke, Okina, Yoshiteru, Wakabayashi, Tadamasa, Fujimori, Koki, Karube, Kenichi, Sakai, Takahiro, Nomi, Hidetomo, Yui, Hisanori, Kanzaki, Yusuke, Machida, Keisuke, Maruyama, Shusaku, Nagae, Ayumu, Saigusa, Tatsuya, Ebisawa, Soichiro, Okada, Ayako, Motoki, Hirohiko, Kuwahara, Koichiro
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.08.2023; Springer Nature B.V
• Subjects: Arteriosclerosis; Atherosclerosis; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Cardiovascular disease; Cardiovascular diseases; Cardiovascular system; Cerebral infarction; Clinical outcomes; Coronary artery disease; Coronary Artery Disease - complications; Coronary Artery Disease - surgery; Coronary vessels; Health risks; Health services; Heart diseases; Humans; Medicine; Medicine & Public Health; Multivariate analysis; Myocardial infarction; Original; Original Article; Patients; Peripheral Arterial Disease - complications; Peripheral Arterial Disease - diagnosis; Peripheral Arterial Disease - surgery; Prospective Studies; Registries; Risk Factors; Treatment Outcome; Vascular diseases; Vascular Surgery; Vein & artery diseases; Peripheral artery disease; Endovascular therapy; Major adverse cardiovascular events; Coronary artery disease; Complete revascularization
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-023-02251-y

Peripheral artery disease (PAD) is commonly caused by atherosclerosis and has an unfavorable prognosis. Complete revascularization (CR) of the coronary artery reduces the risk of major adverse cardiovascular event (MACE) in patients with coronary artery disease (CAD). However, the impact of CR in patients with PAD has not been established to date. Therefore, we evaluated the impact of CR of CAD on the five-year clinical outcomes in patients with PAD. This study was based on a prospective, multicenter, observational registry in Japan. We enrolled 366 patients with PAD undergoing endovascular treatment. The primary endpoint was MACE, defined as a composite of all-cause death, non-fatal myocardial infarction, and non-fatal stroke. After excluding ineligible patients, 96 and 68 patients received complete revascularization of the coronary artery (CR group) and incomplete revascularization of the coronary artery (ICR group), respectively. Freedom from MACE in the CR group was significantly higher than in the ICR group at 5 years (66.7% vs 46.0%, p  < 0.01). Multivariate analysis revealed that CR emerged as an independent predictor of MACE (Hazard ratio: 0.56, 95% confidential interval: 0.34–0.94, p  = 0.03). CR of CAD was significantly associated with improved clinical outcomes in patients with PAD undergoing endovascular treatment.