TY - JOUR
T1 - Ten-year mortality after treating obstructive coronary atherosclerosis with contemporary stents in patients with or without concomitant peripheral arterial disease
AU - Pinxterhuis, Tineke H.
AU - Ploumen, Eline H.
AU - van Vliet, Daphne
AU - van Houwelingen, K. Gert
AU - Stoel, Martin G.
AU - de Man, Frits HAF
AU - Hartmann, Marc
AU - Zocca, Paolo
AU - Linssen, Gerard CM
AU - Geelkerken, Robert H.
AU - Doggen, Carine JM
AU - von Birgelen, Clemens
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/5
Y1 - 2024/5
N2 - Background and aims: Previous studies in percutaneous coronary intervention (PCI) patients showed a higher 3-year adverse event risk, including all-cause mortality, in those with concomitant peripheral arterial disease (PADs). Ten-year data of mortality and causes of death are scarce. This analysis assessed PCI patients, treated with contemporary drug-eluting stents, the impact of concomitant PADs on very long-term mortality, and causes of death. Methods: We assessed PCI all-comers from our center who participated in the TWENTE and DUTCH PEERS trials (clinicaltrials.gov:NCT01066650, NCT01331707), comparing patients with versus without PADs. Life status was checked in the Dutch Personal Records Database; causes of death were obtained from medical records. Results: Of 2705 study patients, 668 (24.7%) died during follow-up: 88/212 (41.5%) patients with PADs and 580/2493 (23.1%) without PADs. In PADs patients, the 10-year rate of all-cause mortality was about twice as high as in patients without PADs (41.5% vs.23.1%, HR: 2.05, 95%-CI: 1.64–2.57, p<0.001). For both groups, the rates of patients dying from various causes of death were: cardiac (14.1% vs .6.8%), vascular (2.8% vs. 1.1%), non-cardiovascular (17.4% vs. 9.8%), and unclear causes (7.1% vs. 5.3%), without a statistically significant between-group difference. When multivariate analysis was adjusted for between-group differences in cardiovascular risk profile, PADs remained predictor of all-cause mortality (adjusted HR: 1.38, 95%-CI: 1.08–1.75, p=0.01). Conclusions: The 10-year all-cause mortality rate in PCI patients with concomitant PADs was almost twice as high as in those without PADs. Age and other traditional cardiovascular risk factors were higher in patients with PADs, but after correction for these confounders PADs still accounted for almost 40% increase in mortality.
AB - Background and aims: Previous studies in percutaneous coronary intervention (PCI) patients showed a higher 3-year adverse event risk, including all-cause mortality, in those with concomitant peripheral arterial disease (PADs). Ten-year data of mortality and causes of death are scarce. This analysis assessed PCI patients, treated with contemporary drug-eluting stents, the impact of concomitant PADs on very long-term mortality, and causes of death. Methods: We assessed PCI all-comers from our center who participated in the TWENTE and DUTCH PEERS trials (clinicaltrials.gov:NCT01066650, NCT01331707), comparing patients with versus without PADs. Life status was checked in the Dutch Personal Records Database; causes of death were obtained from medical records. Results: Of 2705 study patients, 668 (24.7%) died during follow-up: 88/212 (41.5%) patients with PADs and 580/2493 (23.1%) without PADs. In PADs patients, the 10-year rate of all-cause mortality was about twice as high as in patients without PADs (41.5% vs.23.1%, HR: 2.05, 95%-CI: 1.64–2.57, p<0.001). For both groups, the rates of patients dying from various causes of death were: cardiac (14.1% vs .6.8%), vascular (2.8% vs. 1.1%), non-cardiovascular (17.4% vs. 9.8%), and unclear causes (7.1% vs. 5.3%), without a statistically significant between-group difference. When multivariate analysis was adjusted for between-group differences in cardiovascular risk profile, PADs remained predictor of all-cause mortality (adjusted HR: 1.38, 95%-CI: 1.08–1.75, p=0.01). Conclusions: The 10-year all-cause mortality rate in PCI patients with concomitant PADs was almost twice as high as in those without PADs. Age and other traditional cardiovascular risk factors were higher in patients with PADs, but after correction for these confounders PADs still accounted for almost 40% increase in mortality.
KW - UT-Hybrid-D
KW - Coronary artery disease
KW - Drug-eluting stent
KW - Long-term mortality
KW - Percutaneous coronary intervention
KW - Peripheral arterial disease
KW - 10-Year mortality
UR - http://www.scopus.com/inward/record.url?scp=85189835282&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2024.117488
DO - 10.1016/j.atherosclerosis.2024.117488
M3 - Article
AN - SCOPUS:85189835282
SN - 0021-9150
VL - 392
JO - Atherosclerosis
JF - Atherosclerosis
M1 - 117488
ER -