Ten-year mortality after treating obstructive coronary atherosclerosis with contemporary stents in patients with or without concomitant peripheral arterial disease

Tineke H. Pinxterhuis, Eline H. Ploumen, Daphne van Vliet, K. Gert van Houwelingen, Martin G. Stoel, Frits HAF de Man, Marc Hartmann, Paolo Zocca, Gerard CM Linssen, Robert H. Geelkerken, Carine JM Doggen, Clemens von Birgelen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

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.

Original languageEnglish
Article number117488
JournalAtherosclerosis
Volume392
DOIs
Publication statusPublished - May 2024

Keywords

  • UT-Hybrid-D
  • Coronary artery disease
  • Drug-eluting stent
  • Long-term mortality
  • Percutaneous coronary intervention
  • Peripheral arterial disease
  • 10-Year mortality

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