Abstract 15754: The Incidence and Effect of Cardiac Function Decline After Lower Extremity Revascularization

Abstract

Introduction: The impact of cardiac function decline on major adverse limb events (MALE) following lower extremity revascularization (LER) in patients with peripheral arterial disease (PAD) has not been described. Methods: The electronic records of patients undergoing LER for PAD in a single center were reviewed. Two transthoracic echocardiograms were captured, the first within 6 months of LER and the second on later follow-up. Patients were then divided into 2 groups: cardiac function decline (decrease in left ventricular ejection fraction (EF) by ≥10%) or stable cardiac function (reduction in EF<10% or improved EF). Patient characteristics and outcomes were compared, including MALE. Results: Of the 922 patients who underwent LER, 221 (24.0%) experienced a cardiac function decline. Out of the 701 patients with stable cardiac function, 599 (65.0%) had a <10% reduction in EF, and 102 (11.0%) had an EF improvement. Patients with cardiac function decline were more likely to have diabetes mellitus and heart failure. Furthermore, patients with cardiac function decline were more likely to undergo open surgical revascularization. Patients with cardiac function decline demonstrated higher rates of periprocedural bleeding after initial LER. After a 3-year follow-up, patients with cardiac function decline had higher mortality and lower overall frequency of reinterventions. However, Kaplan-Meier analysis revealed no difference in freedom from MALE between the 2 groups. Conclusion: Patients with cardiac function decline after LER for PAD have increased mortality but no significant difference in limb outcomes compared to patients with stable cardiac function.