Abstract
Introduction: Lower extremity artery disease (LEAD) is an arterial occlusive disease associated with high morbidity and mortality. Estimated plasma volume status (ePVS), a marker of plasma volume expansion and contraction, is gaining attention in the field of cardiovascular disease. However, it remains undetermined the impact of ePVS on clinical outcome in patients with LEAD. Methods: We calculated two ePVS using Kaplan-Hakim and Duarte formula in 288 LEAD patients who underwent first endovascular therapy and retrospectively followed during a median follow-up period of 617 days. The primary and secondary endpoints were composite events including all-cause death and major adverse limb events (Death/MALE) and major adverse cardiovascular events (MACE), respectively. Results: ePVS significantly increased with advancing Fontaine class. All patients were divided into two groups based on the median ePVS value. Kaplan-Meier analysis demonstrated high ePVS group had higher incidence of composite events and MACE compared to low ePVS group. A multivariate Cox proportional hazard analysis revealed that ePVS was an independent predictor of Death/MALE and MACE after adjustment for confounding risk factors. Prognostic ability for Death/MALE was significantly improved by addition of ePVS to the basic predictors. These results are consistent with each formula. Conclusions: ePVS was associated with severity of LEAD and clinical outcome, suggesting ePVS could be an additional risk factor for Death/MALE and MACE in LEAD patients who underwent endovascular therapy.
Published Version
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