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| 標題: | Utility of the ACD-GENE-CLI Score in Asian Patients with Critical Limb Ischemia Undergoing Endovascular Interventions |
| 作者: | Chang, Wei-Ting
Huang, Po-Sen
Su, Li-Wei
Liao, Chia-Te
Toh, Han Siong
Chen, Yi-Chen
Ho, Chung-Han
Chen, Zhih-Cherng
Hsu, Po -Chao
Hong, Chon-Seng |
| 貢獻者: | Natl Sun Yat Sen Univ, Sch Med
Natl Sun Yat Sen Univ, Coll Med, Doctoral Program Clin & Expt Med
Natl Sun Yat Sen Univ, Ctr Excellence Metab Associated Fatty Liver Disong, Chon-Seng
Chi Mei Med Ctr, Dept Internal Med, Div Cardiol
Natl Sun Yat Sen Univ, Coll Med, Sch Med
Univ Leuven, KU Leuven, Res Unit Hypertens & Cardiovasc Epidemiol, Studies Coordinating Ctr,Dept Cardiovasc Sci
Chi Mei Med Ctr, Dept Intens Care Med
Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
Chi Mei Med Ctr, Dept Med Res
Southern Taiwan Univ Sci & Technol, Dept Informat Management
Kaohsiung Med Univ Hosp, Dept Internal Med, Div Cardiol
Kaohsiung Med Univ, Sch Med, Fac Med, Dept Internal Med
Chi Mei Med Ctr, Dept Internal Med, Div Cardiol |
| 關鍵字: | ACD-GENE-CLI score
Critical limb ischemia
Clopidogrel |
| 日期: | 2024 |
| 上傳時間: | 2024-12-25 11:05:18 (UTC+8) |
| 出版者: | JAPAN ATHEROSCLEROSIS SOC |
| 摘要: | Aims: Critical limb ischemia (CLI) is an emerging public health threat and lacks a reliable score for predicting the outcomes. The Age, Body Mass Index, Chronic Kidney Disease, Diabetes, and Genotyping (ABCD-GENE) risk score helps identify patients with coronary artery disease who have cytochrome P450 2C19 (CYP2C19) polymorphism-related drug resistance and are at risk for cardiovascular adverse events. However, its application to CLI remains unknown. In this study, we aim to validate a modified ACD-GENE-CLI score to improve the prediction of major adverse limb events (MALEs) in patients with CLI receiving clopidogrel.Methods: Patients with CLI receiving clopidogrel post-endovascular intervention were enrolled prospectively in two medical centers. Amputation and revascularization as MALEs were regarded as the outcomes.Results: A total of 473 patients were recruited, with a mean follow-up duration of 25 months. Except for obesity, old age, diabetes, chronic kidney disease (CKD), and CYP2C19 polymorphisms were significantly associated with MALEs. Using bootstrap regression analysis, we established a modified risk score (ACD-GENE-CLI) that included old age (>= 65 years), diabetes, CKD, and CYP2C19 polymorphisms. At a cutoff value of 8, the ACD-GENE-CLI score was superior to the CYP2C19 deficiency only, and the conventional ABCD-GENE score in predicting MALEs (area under the curve: 0.69 vs. 0.59 vs. 0.67, p=0.01). The diagnostic ability of the ACD-GENE-CLI score was consistent in the external validation. Also, Kaplan-Meier curves showed that in CYP2C19 deficiency, the ABCD-GENE and ACD-GENE-CLI scores could all differentiate patients with CLI who are free from MALEs.Conclusions: The modified ACD-GENE-CLI score could differentiate patients with CLI receiving clopidogrel who are at risk of MALEs. Further studies are required to generalize the utility of the score. |
| 關聯: | Journal of Atherosclerosis And Thrombosis, v.31, n.5, pp.572-586 |
| 顯示於類別: | [行政單位] 456
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