Association Between Critical Limb Ischemia, the Society for Vascular Surgery Wound, Ischemia and Foot Infection (WIfI) Classification System and Arterial Stiffness

Association Between Critical Limb Ischemia, the Society for Vascular Surgery Wound, Ischemia and Foot Infection (WIfI) Classification System and Arterial Stiffness

Arterial stiffness analysis has been done to classify cardiovascular risk. The aim of this article is to analyze whether the group of patients with chronic limb-threatening ischemia (CLTI) has higher arterial stiffness indices than controls. The secondary objectives are to assess whether patients wi...

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Veröffentlicht in:Annals of vascular surgery 2020-02, Vol.63, p.250-258.e2
Hauptverfasser: Mendes-Pinto, Daniel, Rodrigues-Machado, Maria da Glória, Navarro, Túlio Pinho, Dardik, Alan
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container_start_page 250
container_title Annals of vascular surgery
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creator Mendes-Pinto, Daniel
Rodrigues-Machado, Maria da Glória
Navarro, Túlio Pinho
Dardik, Alan
description Arterial stiffness analysis has been done to classify cardiovascular risk. The aim of this article is to analyze whether the group of patients with chronic limb-threatening ischemia (CLTI) has higher arterial stiffness indices than controls. The secondary objectives are to assess whether patients with advanced stages of Wound, Ischemia, and foot Infection (WIfI) classification have high levels of arterial stiffness, through multiple linear regressions to analyze whether the ankle-brachial index (ABI) and other variables are predictive of arterial stiffness. We conducted a cross-sectional study with 66 patients with CLTI and 66 age- and sex-matched controls using brachial artery oscillometry. Hemodynamic and arterial stiffness measurements, clinical characteristics, laboratory data, and stages of WIfI classification were compared between the groups CLTI and controls. Through multiple linear regression, we identified predictors of pulse wave velocity (PWV) and augmentation index normalized to 75 beats/min (AIx@75). Patients with CLTI had PWV (11.8 ± 1.6 m/sec vs. 10.0 ± 1.8 m/sec, P 
doi_str_mv 10.1016/j.avsg.2019.07.017
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The aim of this article is to analyze whether the group of patients with chronic limb-threatening ischemia (CLTI) has higher arterial stiffness indices than controls. The secondary objectives are to assess whether patients with advanced stages of Wound, Ischemia, and foot Infection (WIfI) classification have high levels of arterial stiffness, through multiple linear regressions to analyze whether the ankle-brachial index (ABI) and other variables are predictive of arterial stiffness. We conducted a cross-sectional study with 66 patients with CLTI and 66 age- and sex-matched controls using brachial artery oscillometry. Hemodynamic and arterial stiffness measurements, clinical characteristics, laboratory data, and stages of WIfI classification were compared between the groups CLTI and controls. Through multiple linear regression, we identified predictors of pulse wave velocity (PWV) and augmentation index normalized to 75 beats/min (AIx@75). Patients with CLTI had PWV (11.8 ± 1.6 m/sec vs. 10.0 ± 1.8 m/sec, P < 0.01) and AIx@75 (29.2 ± 9.8% vs.18. ± 10.35%, P < 0.01) higher than controls. In the multiple regression model, there was influence of age (β = 0.17, P < 0.01), antiplatelet therapy (β = −0.15, P = 0.04), peripheral systolic pressure (β = 0.03, P < 0.01), and clustered WIfI stages 3 and 4 (β = 0.17, P = 0.02) of benefit of revascularization on PWV. Multiple regression analysis identified diabetes (β = 7.51, P < 0.01) and the degree of ischemia measured by ABI (β = −23.89, P < 0.01) as predictors of elevated AIx@75. WIfI stages 3 and 4 of estimate risk of amputation at 1 year predicts a high AIx@75 (β = 9.77, P < 0.001) compared with stages 1 and 2. The degree of ischemia in CLTI patients determined by the ABI is associated with elevated arterial stiffness as measured by the AIx@75. 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The aim of this article is to analyze whether the group of patients with chronic limb-threatening ischemia (CLTI) has higher arterial stiffness indices than controls. The secondary objectives are to assess whether patients with advanced stages of Wound, Ischemia, and foot Infection (WIfI) classification have high levels of arterial stiffness, through multiple linear regressions to analyze whether the ankle-brachial index (ABI) and other variables are predictive of arterial stiffness. We conducted a cross-sectional study with 66 patients with CLTI and 66 age- and sex-matched controls using brachial artery oscillometry. Hemodynamic and arterial stiffness measurements, clinical characteristics, laboratory data, and stages of WIfI classification were compared between the groups CLTI and controls. Through multiple linear regression, we identified predictors of pulse wave velocity (PWV) and augmentation index normalized to 75 beats/min (AIx@75). Patients with CLTI had PWV (11.8 ± 1.6 m/sec vs. 10.0 ± 1.8 m/sec, P < 0.01) and AIx@75 (29.2 ± 9.8% vs.18. ± 10.35%, P < 0.01) higher than controls. In the multiple regression model, there was influence of age (β = 0.17, P < 0.01), antiplatelet therapy (β = −0.15, P = 0.04), peripheral systolic pressure (β = 0.03, P < 0.01), and clustered WIfI stages 3 and 4 (β = 0.17, P = 0.02) of benefit of revascularization on PWV. Multiple regression analysis identified diabetes (β = 7.51, P < 0.01) and the degree of ischemia measured by ABI (β = −23.89, P < 0.01) as predictors of elevated AIx@75. WIfI stages 3 and 4 of estimate risk of amputation at 1 year predicts a high AIx@75 (β = 9.77, P < 0.001) compared with stages 1 and 2. The degree of ischemia in CLTI patients determined by the ABI is associated with elevated arterial stiffness as measured by the AIx@75. 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The aim of this article is to analyze whether the group of patients with chronic limb-threatening ischemia (CLTI) has higher arterial stiffness indices than controls. The secondary objectives are to assess whether patients with advanced stages of Wound, Ischemia, and foot Infection (WIfI) classification have high levels of arterial stiffness, through multiple linear regressions to analyze whether the ankle-brachial index (ABI) and other variables are predictive of arterial stiffness. We conducted a cross-sectional study with 66 patients with CLTI and 66 age- and sex-matched controls using brachial artery oscillometry. Hemodynamic and arterial stiffness measurements, clinical characteristics, laboratory data, and stages of WIfI classification were compared between the groups CLTI and controls. Through multiple linear regression, we identified predictors of pulse wave velocity (PWV) and augmentation index normalized to 75 beats/min (AIx@75). Patients with CLTI had PWV (11.8 ± 1.6 m/sec vs. 10.0 ± 1.8 m/sec, P < 0.01) and AIx@75 (29.2 ± 9.8% vs.18. ± 10.35%, P < 0.01) higher than controls. In the multiple regression model, there was influence of age (β = 0.17, P < 0.01), antiplatelet therapy (β = −0.15, P = 0.04), peripheral systolic pressure (β = 0.03, P < 0.01), and clustered WIfI stages 3 and 4 (β = 0.17, P = 0.02) of benefit of revascularization on PWV. Multiple regression analysis identified diabetes (β = 7.51, P < 0.01) and the degree of ischemia measured by ABI (β = −23.89, P < 0.01) as predictors of elevated AIx@75. WIfI stages 3 and 4 of estimate risk of amputation at 1 year predicts a high AIx@75 (β = 9.77, P < 0.001) compared with stages 1 and 2. The degree of ischemia in CLTI patients determined by the ABI is associated with elevated arterial stiffness as measured by the AIx@75. 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title Association Between Critical Limb Ischemia, the Society for Vascular Surgery Wound, Ischemia and Foot Infection (WIfI) Classification System and Arterial Stiffness
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