Abstract 16697: Chronic Venous Insufficiency is Associated With Increased Risk of Limb Events in Patients Undergoing Lower Extremity Revascularization

Abstract

Introduction: Chronic venous disease is associated with an increased risk of cardiovascular (CV) events, possibly due to systemic inflammation and increased oxidative stress. Hypothesis: To evaluate the impact of chronic venous insufficiency (CVI) on the risk of subsequent CV and limb events in patients undergoing lower extremity revascularization (LER). Methods: Real-world data from the University of Colorado health system, which serves a diverse population of rural and urban patients, were extracted from TriNetX (Cambridge, MA, USA) for patients undergoing LER from 2015 to 2022. The cohort was divided into those with vs without concomitant CVI and assessed for subsequent limb events (defined as major amputation or re-intervention) and CV events (defined as stroke, myocardial infarction or death). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated between propensity score (PS)-matched patients with and without CVI. Results: Among 5090 patients with LER, the 1370 (27%) with concurrent CVI were older (67±14 vs. 66±14, p <0.01) and had more comorbidities such as hypertension (72 vs. 58%, p <0.01), diabetes (40 vs. 30%, p <0.01), chronic kidney disease (32 vs. 18%, p <0.01), and obesity (28 vs. 15%, p <0.01). During the 2-years following LER, occurrence of CV (37.2% vs. 31.9%) and limb events (27.0% vs. 18.0%) was higher among patients with CVI (upper panel). After PS matching, limb events remained significantly more frequent (HR 1.53, 95% CI 1.273-1.829) in the group with CVI (lower panel). Conclusion: Among patients undergoing LER, the presence of concurrent CVI identifies a population at significantly increased risk for subsequent limb events.