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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 |
| 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: | [保健營養系(所) ] 期刊論文
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