AI Summary & Key Takeaways
AI InsightDeath and limb amputation occurred only in patients not receiving anticoagulant therapy (12.5%, p=0.02 and 5.4%, p=0.071).Conclusion: In patients with peripheral arterial disease treated surgically, the oral anticoagulant therapy may be effective for preventing death
📌 3 Key Takeaways
Abstract
Objective: Atherosclerotic peripheral arterial disease is associated with an increased risk of myocardial infarction, stroke, and death from cardiovascular causes. Antiplatelet drugs protect from major cardiovascular events, but the role of oral anticoagulant agents is unclear in the prevention of cardiovascular complications in patients with peripheral arterial disease.Material and Methods: We assigned patients with peripheral arterial disease treated surgically. According to the medical treatment in postoperative and follow-up periods, the patients were divided into two groups: Anticoagulant therapy [patients receiving oral anticoagulant agents with a target international normalized ratio (INR)=2.0-3.0, n=78] and the patients not receiving oral anticoagulant agents (n=56). In both groups, medical treatment was combined with antiplatelet therapy in some patients. The primary outcome was death and secondary outcome was limb amputation.Results: A total of 134 patients were treated surgically. The mean follow-up period was 30 months. Revision due to bleeding, occlusion of the graft, embolism of non-treated arteries, myocardial infarction and stroke occurred in 6 patients receiving anticoagulant therapy (7.69%) and in 5 patients not receiving anticoagulant therapy (8.92%, p=0.48). Death and limb amputation occurred only in patients not receiving anticoagulant therapy (12.5%, p=0.02 and 5.4%, p=0.071).Conclusion: In patients with peripheral arterial disease treated surgically, the oral anticoagulant therapy may be effective for preventing death
Özet
Amaç: Aterosklerotik periferik arter hastalığı miyokard enfarktüsü, inme ve kardiyovasküler nedenlere bağlı olarak gelişen ölüm ile riski ile ilişkilidir. Antiplatelet ilaçlar majör kardiyovasküler olaylardan korur, ancak periferik arter hastalığı olan hastalarda kardiyovasküler komplikasyonların önlenmesinde oral antikoagülan ajanların rolü belirsizdir.Gereç ve Yöntemler: Çalışmaya cerrahi olarak tedavi edilen periferik arter hastalığı olan hastaları seçtik. Postoperatif dönemde ve takip sırasında uygulanan tıbbi tedaviye göre hastalar iki gruba ayrıldı: Antikoagülan tedavi alan [oral antikoagülan ajan alan hastalar, hedef uluslararası normalize oranı (INR)=2,0-3,0, n=78] ve oral antikoagülan ajan almayan hastalar, (n=56). Her iki grupta, bazı hastalarda tıbbi tedavi antiplatelet tedavi ile kombine edildi. Birincil sonuç ölüm ve ikincil sonuç ekstremite amputasyonu oldu.Bulgular: Yüz otuz dört hasta cerrahi olarak tedavi edildi. Ortalama takip süresi 30 ay oldu. Kanama nedenli revizyon, greft tıkanması, tedavi edilmemiş arterlerin embolisi, miyokard enfarktüsü ve inme, antikoagülan tedavi alan 6 (%7,69) hastada, antikoagülan tedavi almayan 5 (%8,92) hastada meydana gelmiştir (p=0,48). Ölüm ve ekstremite kaybı sadece antikoagülan tedavi almayan hastalarda görüldü (%12,5, p=0,02 ve %5,4, p=0,071).Sonuç: Cerrahi olarak tedavi periferik arter hastalığı olan hastalarda, oral antikoagülan tedavi ölümü önlemede etkili olabilir.