Key result
Atrial fibrillation was independently associated with increased all-cause mortality in patients with severe lower extremity arterial disease (adjusted HR 2.153; 95% CI 1.084-4.276; p=0.029).
Why the study?
Atrial fibrillation is associated with lower extremity arterial disease, but its impact on prognosis in severe disease remains unclear.
Does atrial fibrillation increase the risk of mortality and MACEs in patients with severe lower extremity arterial disease undergoing angioplasty?
Cohort (n=222)
Does atrial fibrillation increase the risk of mortality and MACEs in patients with severe lower extremity arterial disease undergoing angioplasty?
Answers are grounded in this paper and cite their sources.
Atrial fibrillation is independently associated with a significantly increased risk of one-year all-cause mortality and MACEs in patients with severe lower extremity arterial disease undergoing angioplasty.
Atrial fibrillation (Afib) is associated with the presence of lower extremity arterial disease (LEAD), but its effect on a severe LEAD prognosis remains unclear. We investigated the association between Afib and clinical outcomes. We retrospectively enrolled consecutive severe LEAD patients undergoing percutaneous transluminal angioplasty between 1 January 2013 and 31 December 2018. Patients were divided according to the history of any type of Afib and followed for at least one year. The primary outcome was all-cause mortality. Secondary outcomes were cardiac-related mortality and major adverse cardiovascular events (MACEs). The study included 222 patients aged 74 ± 11 years (54% male), and 12.6% had acute limb ischemia. The Afib group had significantly higher rates of all-cause mortality (42.9% vs. 20.1%, p = 0.014) and MACEs (32.1% vs. 14.4%, p = 0.028) than the non-Afib group. Afib was independently associated with all-cause mortality (adjusted HR: 2.153, 95% CI: 1.084–4.276, p = 0.029) and MACEs (adjusted HR: 2.338, 95% CI: 1.054–2.188, p = 0.037). The other factors associated with all-cause mortality included acute limb ischemia (adjusted HR: 2.898, 95% CI: 1.504–5.586, p = 0.001), Rutherford classification, and heart rate. Afib was significantly associated with increased risks of one-year all-cause mortality and MACEs in patients with severe LEAD. Future studies should investigate whether oral anticoagulants benefit these patients.
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Su et al. (2022) conducted a cohort in Severe lower extremity arterial disease (LEAD) (n=222). Atrial fibrillation vs. No atrial fibrillation was evaluated on All-cause mortality (adjusted HR 2.153, 95% CI 1.084-4.276, p=0.029). Atrial fibrillation was independently associated with increased all-cause mortality in patients with severe lower extremity arterial disease (adjusted HR 2.153; 95% CI 1.084-4.276; p=0.029).
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