ĭespite optimal treatment, the elderly population remains at an increased risk for all-cause mortality. The 2016 European guidelines on CVD prevention in clinical practice place patients with PAD in the very high-risk category. Peripheral artery disease (PAD) is a major noncoronary manifestation of CVD. Ītherosclerotic CVD is characterized by atheromatous plaques that lead to blood flow restrictions and eventually tissue ischemia. Atherosclerotic cardiovascular disease (CVD) is a leading cause of death, and more than two-thirds of CVD-related deaths occur in the geriatric population. Aging represents a key cardiovascular risk factor and is associated with alterations of the cardiovascular system. The global share of people aged 65 years or over is expected to double from 12% in 2010 to 22% by 2040. Further risk stratification through biomarkers in this high-risk population of octo- and nonagenarians with PAD is necessary.Īging is inevitable. Our study demonstrates that cardiovascular biomarkers and CLTI are the primary predictors of increased mortality in elderly PAD patients. In a control group of an equal number of younger individuals, only NT-proBNP (HR: 4.2, 95% CI 1.2–14.1) and CLTI (HR: 6.1, 95% CI 1.6–23.4) were predictive of mortality. Receiver operating characteristic curve analysis using a combination of all predictors yielded an improved area under the curve of 0.888. Multivariate regression revealed that each increment of 1 standard deviation in log troponin and log NT-proBNP was associated with a 2.7-fold (95% CI 1.8–4.1) and a 1.9-fold (95% CI 1.2–2.9) increased risk of all-cause death. The troponin level was the major predictor of all-cause mortality (HR: 4.6, 95% confidence interval : 1.4–15.3), followed by the NT-proBNP level (HR: 3.9, 95% CI 1.8–8.8) and CLTI (HR: 3.1, 95% CI 1.6–5.9). ResultsĪ total of 123 octo- and nonagenarians admitted for PAD were eligible. Hazard ratios were calculated and survival was analyzed by Kaplan-Meyer curves and receiver operating characteristic curved were assessed for troponin-ultra and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and chronic limb-threatening ischemia (CLTI). MethodsĬases of treated octo- and nonagenarians, including the clinical characteristics and markers of myocardial injury and heart failure, were studied retrospectively with respect to all-cause mortality. The objective of this study was to investigate predictors of mortality in octo- and nonagenarians with PAD. ![]() Despite optimal treatments, mortality in the high-risk population of octo- and nonagenarians with PAD remains excessive, and predictive factors need to be identified. The prevalence of peripheral artery disease (PAD) is high in elderly patients and is associated with a worse prognosis. Among changes in demographics, aging is the most relevant cardiovascular risk factor.
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