Impact of co-presence of malnutrition-inflammation-atherosclerosis factors on prognosis in lower extremity artery disease patients after endovascular therapy.

IF 3.1 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Intervention and Therapeutics Pub Date : 2024-10-24 DOI:10.1007/s12928-024-01058-6
Kenta Ohmure, Daisuke Kanda, Yoshiyuki Ikeda, Akihiro Tokushige, Takeshi Sonoda, Ryo Arikawa, Kazuhiro Anzaki, Mitsuru Ohishi
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Abstract

Malnutrition and inflammation are common problems of adverse outcomes in various diseases as atherosclerosis. Recently, the concept of malnutrition-inflammation-atherosclerosis (MIA) syndrome is known to a crucial prognostic factor in patients with end-stage renal disease. We investigated the prognostic impact of the co-presence of MIA factors in patients with lower-extremity artery disease (LEAD) after endovascular therapy (EVT). This retrospective study included 284 patients with LEAD who underwent EVT. MIA factors were defined in patients with: low geriatric nutritional risk index (< 92) as "malnourished"; greater high-sensitivity C-reactive protein levels (≥ 0.1 mg/dL) as "inflamed"; a history of coronary artery revascularization, lacunar or atherothrombotic brain infarction as "atherosclerotic". We examined the relationship between baseline characteristics and major adverse cardiovascular and cerebrovascular events (MACCE) including all-cause mortality. Sixty-two patients (22%) died and 72 patients (25%) had MACCE, including all-cause death. Forty-four (16%) patients had every 3 of MIA (3-MIA) factors. The mean follow-up period was 737 days. Multivariate Cox proportional hazards regression analysis models revealed that 3-MIA factors correlated significantly with all-cause death [hazard ratio (HR) 3.46, 95% confidence interval (CI) 1.89-6.34; p < 0.001] and MACCE (HR 2.91, 95% CI 1.62-5.22; p < 0.001), after adjusting for relevant factors. Kaplan-Meier analysis revealed that the rates of all-cause death (p < 0.001) and MACCE (p < 0.001) were significantly higher when the MIA factors overlapped and are observed in patients with chronic limb-threatening ischemia. Among patients with LEAD after EVT, the co-presence of MIA factors was an independent risk factor for all-cause death and MACCE.

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营养不良-炎症-动脉粥样硬化并存因素对血管内治疗后下肢动脉疾病患者预后的影响。
营养不良和炎症是导致动脉粥样硬化等多种疾病不良后果的常见问题。最近,营养不良-炎症-动脉粥样硬化(MIA)综合征的概念被认为是终末期肾病患者的一个重要预后因素。我们研究了下肢动脉疾病(LEAD)患者在接受血管内治疗(EVT)后,同时存在营养不良-炎症-动脉粥样硬化(MIA)因素对预后的影响。这项回顾性研究纳入了284名接受EVT的下肢动脉疾病患者。MIA因素在患者中的定义是:低老年营养风险指数(LEAD)患者
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来源期刊
Cardiovascular Intervention and Therapeutics
Cardiovascular Intervention and Therapeutics CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
6.30
自引率
12.50%
发文量
68
期刊介绍: Cardiovascular Intervention and Therapeutics (CVIT) is an international journal covering the field of cardiovascular disease and includes cardiac (coronary and noncoronary) and peripheral interventions and therapeutics. Articles are subject to peer review and complete editorial evaluation prior to any decision regarding acceptability. CVIT is an official journal of The Japanese Association of Cardiovascular Intervention and Therapeutics.
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