所属 医学部 医学科（東京女子医科大学病院） 職種 特任准教授
|発表タイトル||Prognostic Impact of Baseline Glycated Hemoglobin Level in Peripheral Artery Disease Patients with and without Hemodialysis|
|発表者・共同発表者||◎城谷翔太, 重城健太郎, 溝渕景子, 石田一世, 南雄一郎, 春木伸太郎, 嵐弘之, 中尾優, 萩原誠久|
|概要||*ポスターセッション（日本語）18 (VD/RF) Diabetes
Background: Both of diabetes (DM)and hemodialysis (HD) are major prognostic factors in patients with peripheral artery disease (PAD). However, the prognostic importance of baseline HbA1c levels in PAD patients with and without HD is unclear.
Methods: This observational study included 643 consecutive patients who received endovascular therapy (EVT). Each of 313 HD and 330 Non-HD patients was divided into 4 groups by the status of DM at EVT; NonDM, Low-DM (HbA1c: -6.0%), Mid-DM (6.1-7.0%), and High-DM (7.1-%) groups. The primary endpoint was major amputation-free survival (AFS).
Results: Kaplan-Meier analysis revealed that DM patients had significantly higher AFS rates in HD group (Figure A). However, in Non-HD group, there was no statistical difference between DM and Non-DM patients. In multivariate Cox regression analysis in HD group, the higher HbA1c-DM group showed the higher hazard ratio (HR) for AFS (Figure B). Whereas, in Non-HD group, HbA1c-DM class adversely associated with HR for AFS.
Conclusion: Comorbidity of DM worsened long-term prognosis in PAD patients receiving HD, but not in those without HD.