Aortic & peripheral vascular diseaseCohort study
The use of evidence-based medical therapy in patients with critical limb-threatening ischaemia
- Retrospective cohort study
- nationwide Danish registries
Authors' conclusion
Patients with CLTI were undertreated with EBM and carried a more adverse prognosis, as compared with patients with MI, despite similar guidelines.
Study context
- Population
- Patients 40–100 years with a first-time hospitalization for critical limb-threatening ischaemia or myocardial infarction (MI), Denmark, 2008–2018
- Participants
- 92,845 patients
- Exposure
- Critical limb-threatening ischaemia (CLTI) and CLTI + MI vs MI
- CLTIn = 14,941
- MIn = 74,830reference
- CLTI + MIn = 3,074
- Outcome
- Filling prescriptions for evidence-based medical therapy (antiplatelets, lipid-lowering agents, angiotensin-converting enzyme inhibitor (ACEi) or ARBs) among survivors
- Follow-up
- Within 3 months after discharge
Main finding
As reported in the abstract
Filling prescriptions for EBM
Each group vs MIOdds ratio (CI)
CLTIantiplatelets; unadjusted
0.15(0.14–0.15)
CLTIlipid-lowering agents; unadjusted
0.26(0.25–0.27)
CLTIARB/ACEi; unadjusted
0.71(0.69–0.74)
CLTI + MIantiplatelets; unadjusted
0.22(0.20–0.24)
CLTI + MIlipid-lowering agents; unadjusted
0.38(0.35–0.42)
CLTI + MIARB/ACEi; unadjusted
1.17(1.08–1.27)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| All-cause mortality (adjusted) · 3 years — CLTI vs MI · adjusted | 1.69 (1.64–1.74) | |
| All-cause mortality (adjusted) · 3 years — CLTI + MI vs MI · adjusted | 1.60 (1.51–1.69) | |
| 0.512Hazard ratio (log scale) |
Original publication
The use of evidence-based medical therapy in patients with critical limb-threatening ischaemia. Eur J Prev Cardiol. Published 27 January 2023. doi:10.1093/eurjpc/zwad022
Summarised from the published abstract; every number is checked against it