Abstract 13743: Prognostic Values of Ratio of Serum Eicosapentaenoic Acid to Arachidonic Acid on Clinical Outcome after Endovascular Therapy in Patients with Peripheral Artery Disease due to Femoropopliteal Artery Lesions

Abstract

Background: Peripheral artery disease (PAD) patients have a substantially increased risk of mortality and cardiovascular morbidity than those without PAD. However, risk prediction tools have not been established among patients with PAD to identify who is likely destined for adverse clinical outcome. Eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio has emerged as predictor of mortality endpoints in vascular diseases, especially, coronary artery disease and cerebrovascular disease. In contrast, the prognostic value of EPA/AA ratios in patients with PAD is unclear. We sought to examine whether assessment of serum ratio of EPA/AA in patients with PAD due to femoropopliteal artery lesions can predict clinical outcome after endovascular therapy (EVT). Methods: We obtained serum EPA/AA ratio in 132 consecutive patients with PAD due to femoropopliteal artery lesions before EVT. We analyzed the incidence of major adverse event (MAE) including major adverse limb event (MALE) and any-cause death. The clinical characteristics and laboratory variables were compared and analyzed between MAE group and non-MAE group. Cox regression analyses were used for survival tests. Receiver operating characteristics (ROC) curve analysis was used to determine an optimal cutoff value for EPA/AA ratio to predict MAE after EVT. Results: At a median follow-up of 17 months, MALE occurred in 39 patients (29.5%) and 10 patients (7.6%) died. Significantly lower level of preprocedural serum EPA/AA ratio was observed in the MAE group than non-MAE group. Multivariable Cox analysis showed critical limb ischemia (hazard ratio, 2.93; 95% confidence interval [CI], 1.59-5.40; P = 0.001) and preprocedural serum EPA/AA ratio (hazard ratio, 0.08; 95% CI, 0.02-0.43; P = 0.003) were independent predictors of MAE after EVT. The cutoff value of EPA/AA ratio via ROC curve analysis was 0.29 (66.3% sensitivity, 73.5% specificity). Conclusions: Our findings suggest that lower serum EPA/AA ratio is associated with a greater risk of MALE and any-cause death after EVT in patients with PAD due to femoropopliteal artery lesions.