Routine coronary revascularization, angiography reasonable strategy in CLI

ANAHEIM, Calif. — Routine coronary angiography and coronary revascularization may be a safe and effective approach for patients with critical limb ischemia at high risk for severe CAD, according to data presented at the American Heart Association Scientific Sessions.

According to an abstract from Seung-Woo Rha, MD, of the cardiovascular center at Korea University Guro Hospital, and colleagues, CLI and CAD are associated with a high risk for mortality and CV events, and patients with CLI have a high prevalence of CAD.

To evaluate long-term clinical outcomes of the strategy of routine coronary angiography and subsequent coronary revascularization in patients with CLI who underwent percutaneous transluminal angioplasty, Rha and colleagues studied data from 674 consecutive patients with CLI.

The researchers defined CAD as angiographic stenosis of at least 70%.

Patients included in the study were divided into two groups according to the presence of CAD (CAD group, n = 413, non-CAD group, n = 261).

Propensity score matching analysis was performed to adjust for potential confounders that could cause bias.

At 5-year clinical follow-up, there were no significant differences between the two groups regarding mortality, MI, stroke, peripheral revascularization and target extremity surgery, Rha and colleagues found.

However, coronary revascularization was higher among patients in the CAD group compared with the non-CAD group (9.3% vs. 0.8%; P < .001), according to the researchers.

According to Rha and colleagues, a randomized trial is needed to determine the preferred treatment strategy for patients with CLI. – by Dave Quaile

Reference:

Rha SW, et al. Abstract 4142. Presented at: American Heart Association Scientific Sessions; Nov. 11-15, 2017; Anaheim, Calif.

Disclosure: Rha reports no relevant financial disclosures.