ArticleCirculation2019
Microvascular Disease, Peripheral Artery Disease, and Amputation.
Article in Circulation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 105 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
SUper-Resolution Ultrasound Imaging of Erythrocytes (SURE) in Normal and Malignant Lymph Nodes
Impact of Nrf2 Activation on Macrovascular Function, Microvascular Function, Leg Function, and Walking Capacity in Patients With Peripheral Artery Disease
Who cites it
105 citing papers in PubMed, 6 syntheses or guidelines pooled it, 187 citations in OpenAlex.
- 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2026.Diabetes care · 2026Guideline
- Association of cognitive impairment and peripheral artery disease (PAD): A systematic review.Vascular medicine (London, England) · 2025Pooled it
- 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- The Influence of Diabetes Mellitus on Mortality of Patients After Lower Extremity Amputation: A Systematic Review and Meta-analysis.World journal of surgery · 2023Pooled it
- Central and peripheral arterial diseases in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.Kidney international · 2021Guideline
- Microvascular Function and Ambulatory Capacity in Peripheral Artery Disease.Circulation. Cardiovascular interventions · 2025Trial
- Moderate dose of dietary nitrate improves skeletal muscle microvascular function in patients with peripheral artery disease.Microvascular research · 2023Trial
- Prognostic Value of Radiotracer-Based Perfusion Imaging in Critical Limb Ischemia Patients Undergoing Lower Extremity Revascularization.JACC. Cardiovascular imaging · 2021Trial
- Trial
- Microvascular dysfunction in chronic kidney disease: A feasibility study.Clinical physiology and functional imaging · 2026Article
- Smoking Behavior and Major Cardiovascular and Limb Events in Patients With Peripheral Artery Disease.JAMA network open · 2026Article
- Extending the Observational Medical Outcomes Partnership Common Data Model to Support Observational Peripheral Vascular Disease Research.The Journal of surgical research · 2026Observational
- Maximal Systolic Acceleration and Near-Infrared Fluorescence Imaging With Indocyanine Green as Predictors for Successful Lower Extremity Revascularization.Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists · 2026Article
- Deep learning-derived retinal biomarker associated with diabetes-related amputation in type 2 diabetes.Frontiers in endocrinology · 2026Observational
- Associations of triglyceride-glucose-related indices and cardiovascular health with retinal arteriosclerosis: a cross-sectional study.Frontiers in public health · 2026Article
- Peripheral artery disease in diabetes.Frontiers in endocrinology · 2026Review
- PTA-DFS study: design of a randomised controlled trial assessing the effects of early percutaneous transluminal angioplasty on the healing of diabetic foot ulcers in persons with type 2 diabetes.BMC cardiovascular disorders · 2025Article
- Neuronal Endothelin a Receptor Mediates Experimental and Clinical Vascular Pain through an Endothelial-Neural Axis.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- High-resolution three-dimensional quantitative photoacoustic and ultrasound imaging of subcutaneous microvasculature in extremities.Biomedical optics express · 2025Article
45 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 12 institutions in 5 countries.
Funding
Abstract
backgroundThe mechanism of adverse limb events associated with peripheral artery disease remains incompletely understood. We investigated whether microvascular disease is associated with amputation in a large cohort of veterans to determine whether microvascular disease diagnosed in any location increases the risk of amputation alone and in concert with peripheral artery disease.
methodsParticipants in the Veterans Aging Cohort Study were recruited from April 1, 2003 through December 31, 2014. We excluded participants with known prior lower limb amputation. Using time-updated Cox proportional hazards regression, we analyzed the effect of prevalent microvascular disease (retinopathy, neuropathy, and nephropathy) and peripheral artery disease status on the risk of incident amputation events after adjusting for demographics and cardiovascular risk factors.
resultsAmong 125 674 veterans without evidence of prior amputation at baseline, the rate of incident amputation over a median of 9.3 years of follow-up was 1.16 per 1000 person-years, yielding a total of 1185 amputations. In time-updated multivariable-adjusted analyses, compared with those without peripheral artery disease or microvascular disease, microvascular disease alone was associated with a 3.7-fold (95% CI, 3.0-4.6) increased risk of amputation; peripheral artery disease alone conferred a 13.9-fold (95% CI, 11.3-17.1) elevated risk of amputation; and the combination of peripheral artery disease and microvascular disease was associated with a 22.7-fold (95% CI, 18.3-28.1) increased risk of amputation.
conclusionsIndependent of traditional risk factors, the presence of microvascular disease increases the risk of amputation alone and synergistically increases risk in patients with peripheral artery disease. Further research is needed to understand the mechanisms by which this occurs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.