Prognostic Usefulness of Metabolic Syndrome Compared with Diabetes in Korean Patients with Critical Lower Limb Ischemia Treated with Percutaneous Transluminal Angioplastyopen access
- Authors
- Won, Ki-Bum; Chang, Hyuk-Jae; Hong, Sung-Jin; Ko, Young-Guk; Hong, Myeong-Ki; Jang, Yangsoo; Choi, Donghoon
- Issue Date
- Jan-2014
- Publisher
- YONSEI UNIV COLL MEDICINE
- Keywords
- Metabolic syndrome; diabetes; critical limb ischemia; angioplasty
- Citation
- YONSEI MEDICAL JOURNAL, v.55, no.1, pp 46 - 52
- Pages
- 7
- Journal Title
- YONSEI MEDICAL JOURNAL
- Volume
- 55
- Number
- 1
- Start Page
- 46
- End Page
- 52
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/75118
- DOI
- 10.3349/ymj.2014.55.1.46
- ISSN
- 0513-5796
1976-2437
- Abstract
- Purpose: Metabolic syndrome (MS) is a clinical condition that shares many common characteristics with diabetes. However, unlike diabetes, the usefulness of MS as a prognostic entity in peripheral arterial disease is uncertain. This study evaluated the prognostic usefulness of MS in critical lower limb ischemia (CLI) patients. Materials and Methods: We compared the 2-year clinical outcomes in 101 consecutive CLI patients (66 +/- 14 years; 78% men) with 118 affected limbs treated with percutaneous transluminal angioplasty (PTA) according to the presence of MS and diabetes. Results: The number of MS patients was 53 (52%), of which 45 (85%) had diabetes. During a 2-year follow-up, the incidence of clinical outcomes, including reintervention, major amputation, minor amputation, and survival, was not significantly different between MS and non-MS patients; however, the incidence of minor amputation was significantly higher in diabetic than in non-diabetic patients (42% vs. 17%; p=0.011). Cox regression analysis for the 2-year primary patency demonstrated no association between MS and 2-year primary patency [hazard ratio (HR), 1.02; 95% confidence interval (CI), 0.45-2.30; p=0.961], whereas there was a significant association between diabetes and 2-year primary patency (HR, 2.81; 95% CI, 1.02-7.72; p=0.046). Kaplan-Meier analysis revealed no significant difference in the 2-year primary patency between MS and non-MS patients; however, the 2-year primary patency was lower in diabetic than in non-diabetic patients (p=0.038). Conclusion: As a prognostic concept, MS might conceal the adverse impact of diabetes on the prognosis of CLI patients treated with PTA.
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