ABSTRACT
OBJECTIVE: In patients with risk factors or established atherothrombosis, atrial fibrillation (AF) is associated with a poor prognosis compared with patients without AF. The aim of this study was to evaluate the prevalence of AF in patients with lower limb amputation (LLA) and its association with cardiovascular death and adverse cardiovascular events in long-term follow-up. METHODS: Observational prospective study of consecutive patients after index major (transfemoral and transtibial) LLA. The primary endpoint was cardiovascular death and secondary endpoint was a composite of adverse cardiovascular events at follow-up (acute myocardial infarction, contralateral lower limb amputation, and ischaemic stroke). RESULTS: Of 282 patients with LLA, 46 (16.3%) patients had AF. AF patients were significantly older compared with patients without AF (median 74.0, IQR 13.0 vs. median 67.0, IQR 14.8 years, p < .001). Diabetes and smoking on the other hand were significantly less prevalent in patients with AF compared with those without AF (41.3% vs. 72.0%, p < .001 and 56.5% vs. 76.3%, p = .01, respectively). 54.3% of patients with AF were on oral anticoagulation therapy. At a median follow-up of 24.0 months (IQR 19.0-32.0), 28.3% patients with AF died of cardiovascular causes versus 17.8% without AF (HRR 1.8, 95% CI 1.0-3.4, p = .06). Adverse cardiovascular events occurred in 32.6% of patients with AF during follow-up versus 22.0% without AF (HRR 1.9, 95% CI 1.0-3.3, p = .03). In multivariate Cox regression analysis, AF (HRR 2.3, 95% CI 1.3-4.2, p = .01) and diabetes (HRR 2.1, 95% CI 1.1-3.9, p = .02) were identified as independent predictors of adverse cardiovascular events during the follow-up. CONCLUSION: AF is common in patients with LLA and associated with higher risk of adverse cardiovascular events during long-term follow-up.
Subject(s)
Amputation, Surgical , Amputees , Atrial Fibrillation/epidemiology , Lower Extremity/surgery , Administration, Oral , Aged , Aged, 80 and over , Amputation, Surgical/adverse effects , Amputation, Surgical/mortality , Anticoagulants/administration & dosage , Atrial Fibrillation/diagnosis , Atrial Fibrillation/drug therapy , Atrial Fibrillation/mortality , Brain Ischemia/epidemiology , Chi-Square Distribution , Comorbidity , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Multivariate Analysis , Myocardial Infarction/epidemiology , Prevalence , Proportional Hazards Models , Prospective Studies , Risk Factors , Serbia/epidemiology , Stroke/epidemiology , Time FactorsABSTRACT
OBJECTIVE: An aortic aneurysm is a general term for an enlargement (dilation) of the aorta to greater than 1.5 times normal size. Abdominal aortic aneurysm (AAA) primarily affects the population older than 50 years, with a prevalence of approximately 5%. There are a few theories about AAA etiology. Interest in the relationship between blood type and vascular disease has been established. The aim of our study is to evaluate distribution of blood-groups among the patients with abdominal aortic aneurysm (AAA) as well as to identify any kind of relationship between blood type and AAA. MATERIALS AND METHODS: The design of our research is combination of retrospective and prospective case-control study in a sample of population of Montenegro. Statistical analysis was performed in SPPS v 20.0, using the chi-square test for independent samples, with the probability level at p < 0.05 as significant, and p < 0.01 as highly significant. RESULTS: O blood group was the most frequent among the examination group (53.11%), and A blood group was the most frequent among group without AAA (43.22%). Presence of AAA in individuals with O blood type was 1.46 higher than for the other blood types. CONCLUSIONS: This finding leads us to suspect that O blood type can be indicator for AAA.
