What question did this study set out to answer?

To determine the short- and long-term postoperative cardiac outcomes of patients undergoing lower extremity revascularization surgery with or without coronary artery disease.

November 1, 1994Journal of the American College of CardiologyOpen Access

Influence of coronary heart disease on morbidity and mortality after lower extremity revascularization surgery: A population-based study in Olmsted County, Minnesota (1970–1987)

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Why the study?

Does the presence of overt coronary artery disease worsen long-term survival and cardiac outcomes in patients undergoing lower extremity revascularization surgery?

Key Points

To determine the short- and long-term postoperative cardiac outcomes of patients undergoing lower extremity revascularization surgery with or without coronary artery disease.
Retrospective population-based study evaluating complete medical records of residents (N=173) who underwent peripheral artery bypass surgery between 1970 and 1987, followed through January 1, 1991.
Patients were categorized into subgroups with overt coronary artery disease (N=60) and without overt coronary artery disease (N=106).
Perioperative 30-day rates of death, myocardial infarction, and stroke showed no significant differences between patient subgroups.
Kaplan-Meier survival at 5 and 10 years was 77% and 51% in patients without coronary disease compared with 54% and 24% in those with overt coronary disease (p < 0.001), while 5-year cardiac event incidence was 50% versus 28% (p = 0.003).
Ten-year survival was significantly higher after aortoiliac bypass than femoropopliteal bypass (47% vs. 28%, p = 0.001), with age, coronary disease, and diabetes identified as independent multivariable predictors of mortality.

Structured PICO

Does the presence of overt coronary artery disease worsen long-term survival and cardiac outcomes in patients undergoing lower extremity revascularization surgery?

Population

173 residents of Olmsted County, Minnesota, who underwent peripheral artery bypass surgery between 1970 and 1987. Subgroups included 60 patients with and 106 patients without overt coronary artery disease.

Intervention

Lower extremity revascularization surgery in patients with overt coronary artery disease

Comparator

Lower extremity revascularization surgery in patients without overt coronary artery disease

Outcome

Short- and long-term postoperative cardiac outcome, including perioperative death, myocardial infarction, or stroke at 30 days, 5- and 10-year survival, and 5-year cumulative incidence of cardiac eventshard clinical

Overt coronary artery disease is a major predictor of long-term mortality and cardiac events after peripheral vascular surgery, though patients without overt disease also face substantial long-term cardiac risk.

Discussion

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Implication

Overt CAD signals poorer survival after lower extremity revascularization; extends risk stratification in observational data but leaves open whether interventions alter outcomes.

Cite This Study

Farkouh et al. (1994) studied this question.

synapsesocial.com/papers/6a725690e5469ee92be25ed0 https://doi.org/10.1016/0735-1097(94)90111-2

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Implication

Overt CAD signals poorer survival after lower extremity revascularization; extends risk stratification in observational data but leaves open whether interventions alter outcomes.

Influence of coronary heart disease on morbidity and mortality after lower extremity revascularization surgery: A population-based study in Olmsted County, Minnesota (1970–1987)

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Influence of coronary heart disease on morbidity and mortality after lower extremity revascularization surgery: A population-based study in Olmsted County, Minnesota (1970–1987)

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider