Abstract
The impact of heart failure (HF) on long-term survival in patients with critical limb ischemia (CLI) has not been well described. Outcomes stratified by left ventricular ejection fraction (EF) are also unknown. A single center retrospective chart review was performed for patients who underwent treatment for CLI from 2006 to 2013. Baseline demographics, procedural data and outcomes were analyzed. HF diagnosis was based on appropriate signs and symptoms as well as results of non-invasive testing. Among 381 CLI patients, 120 (31%) had a history of HF and 261 (69%) had no history of heart failure (no-HF). Within the HF group, 74 (62%) had HF with preserved ejection fraction (HFpEF) and 46 (38%) had HF with reduced ejection fraction (HFrEF). The average EF for those with no-HF, HFpEF and HFrEF were 59±13% vs 56±9% vs 30±9%, respectively. The likelihood of having concomitant coronary artery disease (CAD) was lowest in the no-HF group (43%), higher in the HFpEF group (70%) and highest in the HFrEF group (83%) (p=0.001). Five-year survival was on average twofold higher in the no-HF group (43%) compared to both the HFpEF (19%, p=0.001) and HFrEF groups (24%, p=0.001). Long-term survival rates did not differ between the two HF groups (p=0.50). There was no difference in 5-year freedom from major amputation or freedom from major adverse limb events between the no-HF, HFpEF and HFrEF groups, respectively. Overall, the combination of CLI and HF is associated with poor 5-year survival, independent of the degree of left ventricular systolic dysfunction. u The Author(s) 2017.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 307-315 |
| Number of pages | 9 |
| Journal | Vascular Medicine (United Kingdom) |
| Volume | 22 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 1 2017 |
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Keywords
- critical limb ischemia (CLI)
- heart failure
- left ventricular ejection fraction
- peripheral artery disease (PAD)
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Long-term outcomes in patients with critical limb ischemia and heart failure with preserved or reduced ejection fraction. / Khaira, Kavita B.; Brinza, Ellen; Singh, Gagan; Amsterdam, Ezra A; Waldo, Stephen W.; Tong, Kathleen; Pandya, Kruti; Laird, John R.; Armstrong, Ehrin J.
In: Vascular Medicine (United Kingdom), Vol. 22, No. 4, 01.08.2017, p. 307-315.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term outcomes in patients with critical limb ischemia and heart failure with preserved or reduced ejection fraction
AU - Khaira, Kavita B.
AU - Brinza, Ellen
AU - Singh, Gagan
AU - Amsterdam, Ezra A
AU - Waldo, Stephen W.
AU - Tong, Kathleen
AU - Pandya, Kruti
AU - Laird, John R.
AU - Armstrong, Ehrin J.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - The impact of heart failure (HF) on long-term survival in patients with critical limb ischemia (CLI) has not been well described. Outcomes stratified by left ventricular ejection fraction (EF) are also unknown. A single center retrospective chart review was performed for patients who underwent treatment for CLI from 2006 to 2013. Baseline demographics, procedural data and outcomes were analyzed. HF diagnosis was based on appropriate signs and symptoms as well as results of non-invasive testing. Among 381 CLI patients, 120 (31%) had a history of HF and 261 (69%) had no history of heart failure (no-HF). Within the HF group, 74 (62%) had HF with preserved ejection fraction (HFpEF) and 46 (38%) had HF with reduced ejection fraction (HFrEF). The average EF for those with no-HF, HFpEF and HFrEF were 59±13% vs 56±9% vs 30±9%, respectively. The likelihood of having concomitant coronary artery disease (CAD) was lowest in the no-HF group (43%), higher in the HFpEF group (70%) and highest in the HFrEF group (83%) (p=0.001). Five-year survival was on average twofold higher in the no-HF group (43%) compared to both the HFpEF (19%, p=0.001) and HFrEF groups (24%, p=0.001). Long-term survival rates did not differ between the two HF groups (p=0.50). There was no difference in 5-year freedom from major amputation or freedom from major adverse limb events between the no-HF, HFpEF and HFrEF groups, respectively. Overall, the combination of CLI and HF is associated with poor 5-year survival, independent of the degree of left ventricular systolic dysfunction. u The Author(s) 2017.
AB - The impact of heart failure (HF) on long-term survival in patients with critical limb ischemia (CLI) has not been well described. Outcomes stratified by left ventricular ejection fraction (EF) are also unknown. A single center retrospective chart review was performed for patients who underwent treatment for CLI from 2006 to 2013. Baseline demographics, procedural data and outcomes were analyzed. HF diagnosis was based on appropriate signs and symptoms as well as results of non-invasive testing. Among 381 CLI patients, 120 (31%) had a history of HF and 261 (69%) had no history of heart failure (no-HF). Within the HF group, 74 (62%) had HF with preserved ejection fraction (HFpEF) and 46 (38%) had HF with reduced ejection fraction (HFrEF). The average EF for those with no-HF, HFpEF and HFrEF were 59±13% vs 56±9% vs 30±9%, respectively. The likelihood of having concomitant coronary artery disease (CAD) was lowest in the no-HF group (43%), higher in the HFpEF group (70%) and highest in the HFrEF group (83%) (p=0.001). Five-year survival was on average twofold higher in the no-HF group (43%) compared to both the HFpEF (19%, p=0.001) and HFrEF groups (24%, p=0.001). Long-term survival rates did not differ between the two HF groups (p=0.50). There was no difference in 5-year freedom from major amputation or freedom from major adverse limb events between the no-HF, HFpEF and HFrEF groups, respectively. Overall, the combination of CLI and HF is associated with poor 5-year survival, independent of the degree of left ventricular systolic dysfunction. u The Author(s) 2017.
KW - critical limb ischemia (CLI)
KW - heart failure
KW - left ventricular ejection fraction
KW - peripheral artery disease (PAD)
UR - http://www.scopus.com/inward/record.url?scp=85026903634&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85026903634&partnerID=8YFLogxK
U2 - 10.1177/1358863X17714153
DO - 10.1177/1358863X17714153
M3 - Article
C2 - 28693409
AN - SCOPUS:85026903634
VL - 22
SP - 307
EP - 315
JO - Vascular Medicine (United Kingdom)
JF - Vascular Medicine (United Kingdom)
SN - 1358-863X
IS - 4
ER -