2023-06-12 02:51:47
Domestic multicenter retrospective cohort analysis…minor amputation reduction
[의약뉴스] Triple antiplatelet therapy (cilostazol + aspirin + clopidogrel), which was included in diabetic patients who received endovascular treatment for peripheral arterial disease, showed some benefit compared to double antiplatelet therapy (aspirin + clopidogrel).
On the 10th, the Journal of the American Heart Association (JAHA) published the results of a study in which Korean researchers, including Professor Jeong-Joon Cha of Korea University Anam Hospital, analyzed a cohort of 990 diabetic patients receiving endovascular treatment.
A multicenter study group evaluated the risk of major limb-related events, major amputations, and small amputations with triple antiplatelet therapy and dual antiplatelet therapy in a retrospective cohort analysis of 990 diabetic patients who underwent endovascular treatment for peripheral arterial disease. .
After balancing the propensity scores between the two groups, a total of 350 patients in both groups were followed up for 2 years, and the incidence of major limb-related events was 16.6% for the triple antiplatelet therapy and 19.4% for the double antiplatelet therapy, statistically significant. No significant difference was found. (P=0.260)
There was also no significant difference in the risk of death, major amputation, reintervention, or major bleeding.
However, the risk of minor bleeding was 2.0% and 7.7% (P<0.001) when the propensity scores of the two groups were not balanced, and 2.0% and 6.3% (P=0.004) following balancing, respectively. Slightly lower in ect.
In multivariate Cox regression analysis, end-stage renal disease (HR=2.011, 95% CI 1.445-2.800, P<0.001), coronary artery disease (HR=0.717, 95% CI 0.536-0.959, P=0.025), congestive Heart failure (HR=2.287, 95% CI 1.387-3.772, P=0.001) was identified as an independent predictor.
Independent predictors of small amputation were end-stage renal disease (HR=2.348, 95% CI 1.309-4.212, P=0.004), history of amputation (HR=1.872, 95% CI 1.008-3.475, P=0.047), and fatal limb ischemia. (HR=4.769, 95% CI 1.970-11.543, P=0.001), and triple antiplatelet therapy (HR=0.354, 95% CI 0.158-0.794, P=0.012).
After grouping for propensity score balance, triple antiplatelet therapy remained an independent predictor of small amputation.
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