@Article{duepublico_mods_00077531,
  author = 	{Rammos, Christos
		and Kontogiannis, Aristotelis
		and Mahabadi, Amir A.
		and Steinmetz, Martin
		and Messiha, Daniel
		and Lortz, Julia
		and Rassaf, Tienush},
  title = 	{Risk stratification and mortality prediction in octo- and nonagenarians with peripheral artery disease: a retrospective analysis},
  year = 	{2021},
  month = 	{Aug},
  day = 	{02},
  keywords = 	{Aging; Peripheral interventions; Endovascular treatment; Mortality},
  abstract = 	{Objectives: Among changes in demographics, aging is the most relevant cardiovascular risk factor. The prevalence of peripheral artery disease (PAD) is high in elderly patients and is associated with a worse prognosis. 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 objective of this study was to investigate predictors of mortality in octo- and nonagenarians with PAD. Methods: Cases 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. Hazard ratios [HR] 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). Results: A total of 123 octo- and nonagenarians admitted for PAD were eligible. The troponin level was the major predictor of all-cause mortality (HR: 4.6, 95{\%} confidence interval [CI]: 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). 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. Receiver operating characteristic curve analysis using a combination of all predictors yielded an improved area under the curve of 0.888. 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. Conclusion: Our study demonstrates that cardiovascular biomarkers and CLTI are the primary predictors of increased mortality in elderly PAD patients. Further risk stratification through biomarkers in this high-risk population of octo- and nonagenarians with PAD is necessary.},
  note = 	{<p>The publication of this article was supported by the Publication Fund of the University of Duisburg-Essen.</p>

<p>Open Access funding enabled and organized by Projekt DEAL.</p>},
  note = 	{<p>Rammos, C., Kontogiannis, A., Mahabadi, A.A. <em>et al.</em> Risk stratification and mortality prediction in octo- and nonagenarians with peripheral artery disease: a retrospective analysis. <em>BMC Cardiovasc Disord</em> <strong> 21</strong>, 370 (2021). <a href="https://doi.org/10.1186/s12872-021-02177-1">https://doi.org/10.1186/s12872-021-02177-1</a></p>

<p>Published 02 August 2021</p>},
  note = 	{Version of Record / Verlagsversion},
  doi = 	{10.1186/s12872-021-02177-1},
  url = 	{https://duepublico2.uni-due.de/receive/duepublico_mods_00077531},
  url = 	{https://doi.org/10.1186/s12872-021-02177-1},
  file = 	{:https://duepublico2.uni-due.de/servlets/MCRFileNodeServlet/duepublico_derivate_00077183/BMC_Cardiovasc_Disord_2021_21_370.pdf:PDF},
  language = 	{en}
}