Association between High Bleeding Risk and 2-Year Mortality in Patients with Chronic Limb-Threatening Ischemia
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- Yoshioka Naoki
- Department of Cardiology, Ogaki Municipal Hospital
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- Tokuda Takahiro
- Department of Cardiology, Nagoya Heart Center
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- Koyama Akio
- Department of Vascular Surgery, Ichinomiya Municipal Hospital
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- Yamada Takehiro
- Department of Cardiology, Central Japan International Medical Center
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- Shimamura Kiyotaka
- Department of Cardiology, Shizuoka General Hospital
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- Nishikawa Ryusuke
- Department of Cardiovascular of Medicine, Kyoto University Graduate School of Medicine
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- Morita Yasuhiro
- Department of Cardiology, Ogaki Municipal Hospital
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- Morishima Itsuro
- Department of Cardiology, Ogaki Municipal Hospital
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説明
<p> Aim: Patients with chronic limb-threatening ischemia (CLTI) have a high bleeding risk (HBR) and mortality rate. The 2-year life expectancy is an important factor in deciding the appropriate treatment strategy. This study aimed to assess the influence of HBR on the prognosis of patients with CLTI. </p><p>Methods: A total of 259 patients with CLTI who underwent endovascular therapy (EVT) (mean age, 76.2 years; male, 62.9%) between January 2018 and December 2019 were evaluated. The Academic Research Consortium for HBR (ARC-HBR) criteria were applied to each patient, and the ARC-HBR scores were calculated. The cut-off score for predicting all-cause mortality within two years was derived using a survival classification and regression tree (CART) model. Causes of death and the association between ARC-HBR scores and major bleeding events within two years were also investigated. </p><p>Results: Based on the CART model, patients were divided into three groups (low HBR score 0–1.0, 48 patients; moderate HBR score 1.5–3.0, 176 patients; and high HBR score ≥ 3.5, 35 patients). During the study period, 82 patients (39.6%) died due to cardiac (n=23) and non-cardiac causes (n=59). All-cause mortality increased significantly with increasing ARC-HBR scores. Cox multivariate analysis revealed a significant association between high ARC-HBR scores and the risk of all-cause mortality within two years. Major bleeding events increased significantly with increasing ARC-HBR scores. </p><p>Conclusions: The ARC-HBR score could predict 2-year mortality in patients with CLTI who underwent EVT. Thus, this score can help determine the best revascularization strategy for patients with CLTI.</p>
収録刊行物
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- Ｊｏｕｒｎａｌ ｏｆ Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ ａｎｄ Ｔｈｒｏｍｂｏｓｉｓ
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Ｊｏｕｒｎａｌ ｏｆ Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ ａｎｄ Ｔｈｒｏｍｂｏｓｉｓ 30 (11), 1674-1686, 2023-11-01
一般社団法人 日本動脈硬化学会