Evidence map›Paper›PMID 33094679›Full record

Observational studyVascular and endovascular surgery2021

Characteristics and Outcomes of Patients With Diabetes Mellitus Undergoing Peripheral Vascular Intervention for Infrainguinal Symptomatic Peripheral Artery Disease.

E Hope Weissler, Dennis I Narcisse, Jennifer A Rymer, Ehrin J Armstrong, Eric Secemsky, William A Gray, Jihad A Mustapha, George L Adams, Gary M Ansel, Manesh R Patel and 1 more

Registry-linked trialOpen access · greenAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Vascular and endovascular surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01855412 (LIBERTY 360), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT01855412 completednot on this map

LIBERTY 360: Prospective, Observational, Multi-Center Clinical Study to Evaluate Acute and Long Term Clinical and Economic Outcomes of Endovascular Device Intervention in Patients With Distal Outflow Peripheral Arterial Disease (PAD)

TypeobservationalSponsorAbbott Medical DevicesRan2013 to 2019Enrolled1,204ConditionsPeripheral Arterial Occlusive DiseaseArmsPAD endovascular treatments
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Predicting major adverse limb events in individuals with type 2 diabetes: Insights from the EXSCEL trial.Diabetic medicine : a journal of the British Diabetic Association · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

E Hope WeisslerDivision of Vascular and Endovascular Surgery, 3065Duke University Health System, Durham, NC, USA.ORCID https://orcid.org/0000-0002-8442-6150
Dennis I NarcisseDivision of Cardiology, 3065Duke University Health System, Durham, NC, USA.ORCID https://orcid.org/0000-0003-0898-983X
Jennifer A RymerDivision of Cardiology, 3065Duke University Health System, Durham, NC, USA.
Ehrin J ArmstrongDivision of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA.
Eric SecemskyDivision of Cardiology, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA.
William A GrayMain Line Health, Lankenau Heart Institute, Wynnewood, PA, USA.
Jihad A MustaphaAdvanced Cardiac & Vascular Centers for Amputation Prevention, Grand Rapids, MI, USA.
George L AdamsDivision of Cardiology, UNC REX Healthcare-Raleigh, NC, USA.
Gary M AnselOhioHealth, Columbus, OH, USA.
Manesh R PatelDivision of Cardiology, 3065Duke University Health System, Durham, NC, USA.
W Schuyler JonesDivision of Cardiology, 3065Duke University Health System, Durham, NC, USA.
Duke University Health System · USBeth Israel Deaconess Medical Center · USMain Line Health · USOhioHealth · USRex Hospital · USUniversity of Colorado Denver · US

Funding

Stimulating Access to Research in Residency (StARR) - NHLBIR38HL143612 · NHLBI · DUKE UNIVERSITY · PI Mai ElMallah, David H. Harpole · 2018 to 2026
$2.6M
Shared Decision-Making to Improve the Health Status of Patients with Claudication: Developing and Implementing Strategies to Individualize Treatment DecisionsK23HL150290 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SECEMSKY, ERIC ALEXANDER · 2020 to 2024
$851k
Addressing variability in peripheral arterial disease outcomes using machine learning techniquesF32HL151181 · NHLBI · DUKE UNIVERSITY · PI WEISSLER, ELIZABETH HOPE · 2020 to 2021
$130k
NHLBI NIH HHS F32 HL151181NHLBI NIH HHS K23 HL150290NHLBI NIH HHS R38 HL143612
6 · The paper itself

Abstract

purposePatients with diabetes mellitus (DM) are known to be at higher risk for peripheral artery disease (PAD), amputations, and major adverse cardiovascular events, though it is unclear whether they are at any higher risk for repeat intervention. LIBERTY 360 offered an opportunity to study a real-world cohort of patients who underwent distal superficial femoral artery endovascular revascularizations. We aimed to describe patients with DM, their outcomes following peripheral vascular intervention, and the effect of DM on outcomes in the LIBERTY 360 cohort.

methodsLIBERTY 360 is a prospective, multi-center, non-randomized, mono-industry funded observational study of patients undergoing endovascular revascularization. Outcomes included 30-day and 1-year all-cause mortality, major amputation, target vessel/lesion revascularization, and a composite of those events. A multivariable regression model including DM was constructed to examine the effect of DM on outcomes. Multivariable survival estimates were made using Cox proportional hazards models.

resultsA total of 1,204 patients were enrolled, of whom 727 had DM (60.4%). Patients with DM had significantly more comorbidities and a third required insulin for DM management. Patients with DM had more severe disease based on Rutherford classification at baseline. After adjusting for comorbidities and disease severity, DM patients had more frequent major amputations at 1 year (5.2% versus 1.2%; HR 2.71, 95%CI 1.05-6.98, p = 0.040). The 1-year rates of all-cause mortality and target vessel/lesion revascularization were not significantly higher for patients with DM.

conclusionsDiabetes mellitus was associated with increased major amputations at 1 year following endovascular revascularization after accounting for demographics, comorbidities, and PAD-related characteristics. Further research is needed to determine which aspects of PAD and DM are most strongly associated with poor outcomes following lower extremity revascularization.

Indexed as

Diabetes MellitusEndovascular ProceduresFemoral ArteryAgedAged, 80 and overAmputation, SurgicalFemaleHumansLimb SalvageMaleMiddle AgedPeripheral Arterial DiseaseProspective StudiesRisk FactorsTime FactorsTreatment Outcomechronic limb threatening ischemiadiabetes mellitusendovascular interventionlower extremity interventionperipheral artery disease

Identifiers

PMID33094679
PMCPMC8150867
OpenAlexW3094038041

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.