Impact of the Coexisting Coronary Artery Disease on Five-Year Outcomes in Lower Extremity Artery Disease Patients Without Chronic Limb-Threatening Ischemia.

Abstract

Coronary artery disease (CAD) is often noted in patients with lower-extremity artery disease (LEAD). However, the effects of CAD on patients with LEAD have not been clearly investigated. In this study, to investigate the effect of CAD on patients with LEAD without chronic limb-threatening ischemia (CLTI), we compared the five-year clinical outcomes of patients with and without CAD. Between 2014 and 2017, 246 patients with symptomatic LEAD without CLTI underwent endovascular treatment. Patients with a history of CAD revascularization or CAD defined by CAD studies were divided into CAD groups, and others were non-CAD groups. After excluding ineligible patients, propensity matching produced 40 patients in each group, and clinical outcomes were compared between the groups. Using five years of Kaplan-Meier analysis between the CAD and non-CAD groups, no significant differences were observed in survival (90.0% vs 92.5%, p=0.693), freedom from cardiovascular events (42.5% vs 57.5%, p=0.110), freedom from LEAD revascularization (67.5% vs 67.5%, p=0.940), and freedom from CLTI (100% vs. 95.0%, p=0.148). However, significant differences were observed in freedom from CAD revascularization (67.5% vs 97.5%, p<0.001) and freedom from symptomatic CAD (85.0% vs 97.5%, p=0.048). Our results suggest that in patients with LEAD without CLTI, CAD caused increased CAD revascularization and symptomatic CAD. However, CAD did not affect survival, cardiovascular events, LEAD revascularization, or CLTI in such patients. When CAD was observed in patients with LEAD without CLTI, more frequent follow-up of CAD may improve the long-term clinical outcomes of such patients.