Influence of preprocedural glycemic control on clinical outcomes of endovascular therapy in diabetic patients with lower extremity artery disease: an analysis from a Korean multicenter retrospective registry cohort
Rattachement africain : kr. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: The influence of intensive glucose control in diabetic patients on the macrovascular outcomes is controversial. Thus, this study aimed to elucidate the effect of preprocedural hemoglobin A1c (HbA1c) on clinical outcomes after endovascular therapy for lower extremity artery disease (LEAD) in diabetic patients. METHODS: Diabetic patients were enrolled from the retrospective cohorts of a Korean multicenter endovascular therapy registry and were divided according to the HbA1c level during index admission into the optimal (< 7.0%) or suboptimal (≥ 7.0%) glycemic control groups. The primary endpoints were major adverse limb events (MALE, a composite of major amputation, minor amputation, and reintervention). RESULTS: Of the 1103 patients enrolled (897 men, mean age 68.2 ± 8.9 years), 432 (39.2%) were classified into the optimal glycemic control group and 671 (60.8%) into the suboptimal glycemic control group. In-hospital events and immediate procedural complications were not different between the two groups. The suboptimal group showed a trend towards a higher incidence of MALE than the optimal group (log-rank p = 0.072). Although no significant differences were found between the two groups in terms of overall survival or amputation, the risk of reintervention was significantly higher in the suboptimal group (log-rank p = 0.048). In the multivariate Cox regression model, suboptimal glycemic control was one of the independent predictors for reintervention. When our data were analyzed according to the initial presentation, suboptimal preprocedural HbA1c significantly increased the incidence of MALE compared with optimal preprocedural HbA1c only in patients with intermittent claudication. CONCLUSION: In diabetic patients undergoing endovascular therapy for LEAD, suboptimal preprocedural HbA1c is associated with an increased risk of adverse limb events, especially in patients with intermittent claudication. Further prospective research will be required to validate the role of more intensive glycemic control on the reduction of adverse limb events in diabetic patients undergoing endovascular therapy for LEAD.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Influence of preprocedural glycemic control on clinical outcomes of endovascular therapy in diabetic patients with lower extremity artery disease: an analysis from a Korean multicenter retrospective registry cohort
- Date Crossref
- 22/06/2020
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Yonsei University Department of Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Korea University Medical Center pays non établi dans la noticeÉtablissement de santé
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Gangnam Severance Hospital pays non établi dans la noticeÉtablissement de santé
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Korea University Anam Hospital Department of Internal Medicine pays non établi dans la noticeÉtablissement de santé
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Korea Health Promotion Institute pays non établi dans la noticeOrganisation à but non lucratif
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Yonsei University Health System pays non établi dans la noticeÉtablissement de santé
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Chungnam National University Hospital Department of Internal Medicine pays non établi dans la noticeÉtablissement de santé
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Seoul National University Bundang Hospital Division of Cardiology pays non établi dans la noticeÉtablissement de santé
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Ulsan College Department of Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Asan Medical Center pays non établi dans la noticeÉtablissement de santé
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University of Ulsan pays non établi dans la noticeUniversité ou école supérieure
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Jeonbuk National University Hospital pays non établi dans la noticeÉtablissement de santé
Department of Internal Medicine — Yonsei University, Korea University Medical Center et Gangnam Severance Hospital, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.