The Impact of Coronary Artery Disease in Patients With Peripheral Artery Disease Undergoing Lower-Extremity Revascularization for Chronic Limb-Threatening Ischemia

The most severe form of peripheral artery disease (PAD), chronic limb-threatening ischemia (CLTI), is marked by rest pain, nonhealing ulcers, or gangrene. PAD, a manifestation of atherosclerosis, significantly increases the risk of major adverse cardiovascular events (MACEs) and death. More than half of patients with less severe PAD also have coexistent coronary artery disease (CAD). The BEST-CLI trial (Best Endovascular vs Best Surgical Therapy in Patients With Critical Limb Ischemia; URL: https://www.clinicaltrials.gov; Unique identifier: NCT02060630) tested the optimal method of infrainguinal revascularization. The primary outcome was a composite of major adverse limb events (MALEs) or death from any cause. MACEs, MALEs, and total death were secondary outcomes. We examined the effect of CAD on these outcomes in BEST-CLI participants.