Lower Limb Arterial Calcification and Acute Thrombosis Risk in Patients with Peripheral Artery Disease.

ABSTRACT

BACKGROUND: Calcification is closely related to in situ thrombosis secondary to plaque rupture in the coronary artery. However, the association between calcification in lower extremity arteries and acute thrombosis has not been assessed. We thus sought to determine whether lower limb arterial calcification (LLAC) was correlated with acute thrombosis in patients with symptomatic peripheral artery disease (PAD). METHODS: We retrospectively reviewed consecutive patients presenting with symptomatic PAD between April 2017 and March 2018 who underwent lower extremity arterial evaluation by computed tomography (CT) angiography. Patient characteristics and cardiovascular risk factors were recorded, and LLAC scores were determined by noncontrast CT scans. Univariate and multivariate logistic regression was used to identify factors associated with acute thrombosis. RESULTS: The record search identified 201 patients with symptomatic PAD, including 24 with acute thrombosis and 177 without. Patients in the acute thrombosis group were significantly younger (P = 0.04) and had less diabetes mellitus (P = 0.04). Patients with acute thrombosis had more advanced ischemia at presentation (P < 0.01) and higher amputation rate within 30 days (P < 0.01). Univariate regression showed a significant association among acute thrombosis and age, diabetes mellitus, and LLAC score; in multivariable analysis, only the LLAC score (odds ratio 0.60, 95% confidence interval 0.37-0.98) maintained an association with acute thrombosis after adjusting for relevant risk factors. CONCLUSIONS: The LLAC score is independently and inversely associated with acute thrombosis in patients with PAD.