Background and Aims Patients undergoing revascularization for lower extremity arterial disease (LEAD) may face a higher risk of mortality than those with coronary artery disease (CAD). This study aimed to characterize the difference in mortality risk between patients undergoing revascularization for LEAD and CAD and identify associated factors. Methods The 1-year database of 10 754 patients undergoing revascularization for CAD (n = 6349) and LEAD (n = 4405) was analysed. Poisson regression models were used to characterize interpopulation differences in mortality, adjusting for baseline clinical features, including age, sex, polyvascular disease, comorbidities, medications, and vulnerabilities. Results Individuals with LEAD were older, were more likely to have polyvascular disease, had more comorbidities, and received fewer cardioprotective drugs than those with CAD. Vulnerabilities remained more common in the LEAD group even after adjusting for these clinical features. The crude risk ratio of mortality incidence for LEAD vs. CAD was 2.91 (95% confidence interval, 2.54–3.34), attenuated to 2.14 (1.83–2.50) after controlling for age, sex, and polyvascular disease. The percentage attenuation in the excessive mortality associated with LEAD was 29%. The stepwise addition of comorbidities, medications, and vulnerabilities as adjusting factors attenuated the incidence risk ratio to 1.48 (1.26–1.72), 1.33 (1.12–1.58), and 1.17 (0.98–1.39), respectively, and increased the percentage attenuation to 64%, 73%, and 86%, respectively. Conclusions Mortality risk was almost three-fold higher in patients undergoing revascularization for LEAD than in those with CAD. The excessive mortality was considerably attributable to inter-group differences in baseline characteristics, including potentially clinically or socially modifiable factors.

中文翻译：

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下肢动脉疾病与冠状动脉疾病：血运重建后的死亡率差异

背景和目的 因下肢动脉疾病 (LEAD) 接受血运重建的患者可能比冠状动脉疾病 (CAD) 患者面临更高的死亡风险。本研究旨在描述接受 LEAD 和 CAD 血运重建的患者之间死亡风险的差异，并确定相关因素。方法 对 10 754 例因 CAD (n = 6349) 和 LEAD (n = 4405) 接受血运重建的患者的 1 年数据库进行分析。泊松回归模型用于描述人群间死亡率差异，并调整基线临床特征，包括年龄、性别、多血管疾病、合并症、药物和脆弱性。结果 与 CAD 患者相比，LEAD 患者年龄更大，更有可能患有多血管疾病，有更多合并症，并且接受的心脏保护药物更少。即使在调整这些临床特征后，LEAD 组中的脆弱性仍然更常见。 LEAD 与 CAD 的死亡率发生率粗风险比为 2.91（95% 置信区间，2.54-3.34），在控制年龄、性别和多血管疾病后衰减至 2.14（1.83-2.50）。与 LEAD 相关的过度死亡率衰减百分比为 29%。逐步添加合并症、药物和脆弱性作为调整因素，将发病风险比分别衰减至 1.48 (1.26–1.72)、1.33 (1.12–1.58) 和 1.17 (0.98–1.39)，并将衰减百分比增加至 64分别为 %、73% 和 86%。结论 接受 LEAD 血运重建的患者的死亡风险几乎是 CAD 患者的三倍。死亡率过高在很大程度上归因于基线特征的组间差异，包括潜在的临床或社会可改变因素。