Impact of Serum Zinc Level and Oral Zinc Supplementation on Clinical Outcomes in Patients Undergoing Infrainguinal Bypass for Chronic Limb-Threatening Ischemia

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  • Kodama Akio
    Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University School of Medicine
  • Komori Kimihiro
    Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University School of Medicine
  • Koyama Akio
    Department of Vascular Surgery, Ichinomiya Municipal Hospital
  • Sato Tomohiro
    Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University School of Medicine
  • Ikeda Shuta
    Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University School of Medicine
  • Tsuruoka Takuya
    Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University School of Medicine
  • Kawai Yohei
    Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University School of Medicine
  • Niimi Kiyoaki
    Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University School of Medicine
  • Sugimoto Masayuki
    Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University School of Medicine
  • Banno Hiroshi
    Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University School of Medicine
  • Nishida Kazuki
    Biostatistics and Bioinformatics Section, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital

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<p>Background: Zinc (Zn) has been reported to play an important role in wound healing (WH). Nevertheless, the effect of Zn in chronic limb-threatening ischemia (CLTI) patients is unclear. This study investigated the effect of Zn on the clinical outcomes of CLTI patients undergoing bypass surgery.</p><p>Methods and Results: This study reviewed 111 consecutive patients who underwent an infrainguinal bypass from 2012 to 2020. Patients with Zn deficiency (serum Zn level <60 μg/dL) received oral Zn supplementation and maintained a normal level until WH. This study aimed to explore: (1) the effect of Zn deficiency; and (2) Zn supplementation in Zn-deficient patients on the clinical outcomes of this cohort. Patients with Zn deficiency, Zn supplementation, and no Zn supplementation despite Zn deficiency accounted for 48, 21, and 42 patients, respectively. (1) Zn deficiency was associated with WH (HR, 0.47; 95% CI, 0.29–0.78: P=0.003), major adverse limb events (MALE) (HR, 2.53; 95% CI, 1.26–5.09: P=0.009), and major amputation or death (HR, 3.17; 95% CI, 1.51–6.63: P=0.002). (2) Zn supplementation was positively related to WH (HR, 2.30; 95% CI, 1.21–4.34: P=0.011). This result was confirmed using propensity score matching (HR, 2.24; 95% CI, 1.02–4.87: P=0.043).</p><p>Conclusions: The current study revealed that Zn level was associated with clinical outcomes in CLTI patients after bypass surgery. Oral Zn supplementation could improve WH in these patients.</p>

Journal

  • Circulation Journal

    Circulation Journal 86 (6), 995-1006, 2022-05-25

    The Japanese Circulation Society

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