Abstract 16424: Comparative Outcomes of Interventions for Peripheral Arterial Disease in Patients With Different Atherosclerotic Cardiovascular Disease Risk Estimates

Abstract

Introduction: The atherosclerotic cardiovascular disease (ASCVD) Risk Estimator is an effective tool for predicting cardiovascular events. While peripheral arterial disease (PAD) represents an advanced form of atherosclerosis, ASCVD scores have not been studied in this patient population. This study will evaluate ASCVD risk scores in patients undergoing lower extremity revascularization (LER) for PAD and assess their impact on outcomes. Hypothesis: Patients with high ASCVD risk have worse outcomes after LER for PAD compared to those with lower risk. Methods: Electronic medical records of patients undergoing LER for PAD in a single center from 2013-2020 were reviewed. The ACC/AHA ASCVD estimator was used to calculate risk and categorize patients into risk groups before initial LER. Patient characteristics and outcomes were compared between those with high (≥20%) and lower (<20%) risk scores. The lower risk group was composed of patients with intermediate, borderline, and low ASCVD risk. Results: A total of 635 patients were included and 429 (67.6%) had high ASCVD risk scores. Most patients in the lower risk group had intermediate (78%, N=161) risk, followed by low (12%, N=28), and borderline (8%, N=17) risk scores. High risk patients were more commonly males with more severe comorbidities. ( Table) Patients with high ASCVD risk had more long-term mortality (29% vs 19%, P=0.010) and inferior amputation-free survival ( Figure ) compared to those with lower risk. Conclusions: Most patients with PAD undergoing LER have high ASCVD risk. High ASCVD risk scores correlate with outcomes and may be useful for risk stratification in PAD patient populations with advanced atherosclerosis.