P5191Long term outcomes of patients with both critical limb ischemia and coronary artery disease after endovascular therapy or surgical treatment

Purpose: To investigate the long term outcomes of patients with both critical limb ischemia (CLI) and coronary artery disease (CAD) after endovascular therapy (EVT) or surgical treatment. Methods: We analyzed the outcomes of 910 patients who underwent EVT for CLI from September 2004 to March 2016 at our Hospital Japan. In addition to that, among them, we selected and analyzed 472 CLI patients who had also CAD at the time of first treatment for CLI. Result: The mean follow-up was 5.27±3.6 years. At 5 years in the patients group with CAD, overall survival and freedom from MACE (Major Adverse Cardiovascular Events) were significantly lower (36.3% vs 23.5% P≤0.002; 40.5% vs 20.2%,P<0.001). Among the patients with CAD, in the patients group with multiple-vessel disease (double or triple-vessel disease), freedom from MACE was significantly lower (13.0% vs 37.9% P=0.032) at 5 years. On the other hand, overall survival did not differ significantly between the two groups. On multivariate analysis, high BMI (more than 25) (hazard ratio [HR] 1.22, 95% 1.01 to 1.46 P=0.029) was the independent predictor of CAD in CLI patients. And, high BMI (more than 25) (hazard ratio [HR] 1.47, 95% 1.04 to 2.09 P=0.019) and hypertension (hazard ratio [HR] 1.39, 95% 1.06 to 1.82 P=0.027) were the independent predictors of multiple-vessel disease in patients with both CLI and CAD.