Prognostic Usefulness of Metabolic Syndrome Compared with Diabetes in Korean Patients with Critical Lower Limb Ischemia Treated with Percutaneous Transluminal Angioplasty.
- Author:
Ki Bum WON
1
;
Hyuk Jae CHANG
;
Sung Jin HONG
;
Young Guk KO
;
Myeong Ki HONG
;
Yangsoo JANG
;
Donghoon CHOI
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Metabolic syndrome; diabetes; critical limb ischemia; angioplasty
- MeSH: Aged; Aged, 80 and over; Angioplasty/*methods; Diabetes Mellitus/*therapy; Female; Humans; Ischemia/*therapy; Lower Extremity/*blood supply; Male; Metabolic Syndrome X/*therapy; Middle Aged; Republic of Korea; Retrospective Studies
- From:Yonsei Medical Journal 2014;55(1):46-52
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Metabolic syndrome (MS) is a clinical condition that shares many common characteristics with diabetes. However, unlike diabetes, the usefulness of MS as a prognostic entity in peripheral arterial disease is uncertain. This study evaluated the prognostic usefulness of MS in critical lower limb ischemia (CLI) patients. MATERIALS AND METHODS: We compared the 2-year clinical outcomes in 101 consecutive CLI patients (66+/-14 years; 78% men) with 118 affected limbs treated with percutaneous transluminal angioplasty (PTA) according to the presence of MS and diabetes. RESULTS: The number of MS patients was 53 (52%), of which 45 (85%) had diabetes. During a 2-year follow-up, the incidence of clinical outcomes, including reintervention, major amputation, minor amputation, and survival, was not significantly different between MS and non-MS patients; however, the incidence of minor amputation was significantly higher in diabetic than in non-diabetic patients (42% vs. 17%; p=0.011). Cox regression analysis for the 2-year primary patency demonstrated no association between MS and 2-year primary patency [hazard ratio (HR), 1.02; 95% confidence interval (CI), 0.45-2.30; p=0.961], whereas there was a significant association between diabetes and 2-year primary patency (HR, 2.81; 95% CI, 1.02-7.72; p=0.046). Kaplan-Meier analysis revealed no significant difference in the 2-year primary patency between MS and non-MS patients; however, the 2-year primary patency was lower in diabetic than in non-diabetic patients (p=0.038). CONCLUSION: As a prognostic concept, MS might conceal the adverse impact of diabetes on the prognosis of CLI patients treated with PTA.
