Gender-related differences in patients with obliterating lower extremity arterial disease

Abstract

Aim: to identify gender-related differences in the prognosis of patients with obliterating atherosclerosis of lower extremity arteries (LEA) in the outpatient setting and to determinefactors, associated withfatal outcomes in men and women. Material and Methods. 453 patients with obliterating atherosclerosis of lower extremity arteries who were examined by interventional cardiologist in the Kemerovo Cardiology Center in the period from 2009 to 2013 were retrospectively reviewed. All patients were assigned to two groups: Group 1 - female patients (n - 93), and Group II - malepatients (n - 360). Results. Women were commonly older than men, and had higher body mass index. Women suffered more of ten from arterial hypertension and diabetes (p > 0.05). Thus, smokers prevailed among men (p <0.001). The rate of the major adverse events was assessed in both groups. 5 patients (5.4%) died in Group 1, and 36 patients (10%) - in Group 2 (p = 0.165). 8 (8.6%) women and 23 (6.4%) men had myocardial infarction (MI) and stroke (p> 0.05). 8 male patients (2.2%) underwent amputation (p = 0.146). According to the logistic regression analysis, the independent predictorsfor adverse events in the group of male patients included the presence of angina pectoris and verified coronary artery disease (p - 0.014 vsp - 0.032), internal carotid artery stenosis (p = 0.013), LEA stenosis > 50%, p - 0.033), a positive history of amputation (p - 0.004), and chronic renalfailure (p - 0.012). Multivariate analysis performed in the group of female patients reported that previous MI and elevated pulmonary artery systolic pressure (PASP) contributed to the increased likelihood of adverse events (p - 0.066 vsp - 0.072). Conclusion. 'There were no significant gender-related differencesfound in the incidence of adverse outcomes within the 3-year follow-up of patients with obliterating atherosclerosis of lower extremity arteries (p > 0.05). The factors associated with adverse events in the group of malepatients included the presence of cardiac pathology, renal insufficiency, severe peripheral arterial stenoses, and a positive history of lower extremity amputation of the lower limbs. Thus, the factors contributing to the increased likelihood of major adverse outcomes in the group of female patients were as follows: prior MI and elevated PASP. The results of the study should be taken into account when developing personalised treatment regimen and prevention programs for men and women with obliterating atherosclerosis of lower extremity arteries.