kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2023-12-1-142-150kpccz-1315Research ArticleОНЛАЙН. ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ. Кардиология. Сердечно-сосудистая хирургияONLINE. ORIGINAL STUDIES. Cardiology. Cardiovascular surgeryOutpatient management of patients with peripheral artery disease by cardiologists or surgeons: influence on the prognosis and prevalence of surgical interventionsOutpatient management of patients with peripheral artery disease by cardiologists or surgeons: influence on the prognosis and prevalence of surgical interventionshttps://orcid.org/0000-0002-0963-4793SuminA. N.SuminA. N.

Sumin Aleksey N., MD DrSci, Head of the Laboratory of Comorbidity in Cardiovascular Diseases, Department of Clinical Cardiology, 

6, Sosnoviy Blvd., Kemerovo, 650002

Sumin Aleksey N., MD DrSci, Head of the Laboratory of Comorbidity in Cardiovascular Diseases, Department of Clinical Cardiology, 

6, Sosnoviy Blvd., Kemerovo, 650002

an_sumin@mail.ruhttps://orcid.org/0000-0003-4543-2459MedvedevaYu. D.MedvedevaYu. D.

Medvedeva Yulia D., Cardiovascular Surgeon, Clinical and Diagnostic Department, 

6, Sosnoviy Blvd., Kemerovo, 650002

Medvedeva Yulia D., Cardiovascular Surgeon, Clinical and Diagnostic Department,

6, Sosnoviy Blvd., Kemerovo, 650002

https://orcid.org/0000-0002-4108-164XShcheglovaA. V.ShcheglovaA. V.

Shcheglova Anna V., PhD, Researcher, Laboratory of Comorbidity in Cardiovascular Diseases, Department of Clinical Cardiology, 

6, Sosnoviy Blvd., Kemerovo, 650002

Shcheglova Anna V., PhD, Researcher, Laboratory of Comorbidity in Cardiovascular Diseases, Department of Clinical Cardiology, 

6, Sosnoviy Blvd., Kemerovo, 650002

https://orcid.org/0000-0002-9070-5527IvanovS. V.IvanovS. V.

Ivanov Sergey V., MD, DrSci, Leading Researcher, Laboratory of Endovascular and Reconstructive Surgery of the Heart and Vessels, Department of Heart and Vascular Surgery, 

6, Sosnoviy Blvd., Kemerovo, 650002

Ivanov Sergey V., MD, DrSci, Leading Researcher, Laboratory of Endovascular and Reconstructive Surgery of the Heart and Vessels, Department of Heart and Vascular Surgery, 

6, Sosnoviy Blvd., Kemerovo, 650002

https://orcid.org/0000-0001-6981-9661BarbarashL. S.BarbarashL. S.

Barbarash Leonid S., Academician of the Russian Academy of Sciences, DrSci, Professor, Chief Researcher, 

6, Sosnoviy Blvd., Kemerovo, 650002

Barbarash Leonid S., Academician of the Russian Academy of Sciences, DrSci, Professor, Chief Researcher,

6, Sosnoviy Blvd., Kemerovo, 650002

Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”РоссияFederal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”Russian Federation202331032023121142150Copyright © Sumin A.N., Medvedeva Y.D., Shcheglova A.V., Ivanov S.V., Barbarash L.S., 20232023Sumin A.N., Medvedeva Y.D., Shcheglova A.V., Ivanov S.V., Barbarash L.S.Sumin A.N., Medvedeva Y.D., Shcheglova A.V., Ivanov S.V., Barbarash L.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/1315Highlights

Highlights. The study shows for the first time that during the three-year follow-up of patients with diseases of the arteries of the lower extremities in the observation groups of a general surgeon and a cardiologist, adverse events (myocardial infarction, stroke, amputation, disability) and deaths occurred more often in a surgeon than a cardiologist. The study proves the correctness and real benefit of such an approach with the involvement of a cardiologist to the outpatient stage of management of a complex cohort of patients with atherosclerosis of the vessels of the lower extremities.

Aim

Aim. To study the effect the outpatient observation of patients with peripheral arteries disease (PAD) by cardiologists and surgeons has on timing and prevalence of reconstructive surgery and the prognosis of patients. Methods We analyzed the data on 585 PAD patients who underwent outpatient observation from 2010 to 2017, dividing them into 2 groups. The first group (131 patients) managed by an surgeon; the second (454 patients) managed by a cardiologist. Since the groups were not comparable in terms of the initial parameters, the comparability of patients in the groups (observation by a surgeon or by a cardiologist) was achieved using pseudorandomization. The follow-up period was three years; we assessed the incidence of deaths, adverse events, and the prevalence of reconstructive operations.

Results

Results. During a three-year follow-up the 1st group, compared with the 2nd, had more deaths in general (p<0.001), death from cardiac causes (p = 0.045), from stroke (p><0.001), as well as the total number of adverse events (p><0.001) and disability (p = 0.065). Indications for reconstructive surgery on the lower extremities arteries (LEA), and operations frequency were comparatible in groups. Amputation history, taking diuretics, presence of rhythm disturbances, and management by a surgeon increased the risk of adverse outcomes. Management by a cardiologist, reconstructive LEA surgeries, female sex improved the prognosis of patients. Conclusion Observation of PAD patients by a cardiologist contributes to a higher frequency of optimal drug therapy by patients and can reduce the number of adverse events in patients and improve their survival without affecting the timing and frequency of reconstructive LEA surgeries. Keywords Peripheral atherosclerosis • Outpatient follow-up • Optimal drug therapy • Reconstructive surgery>˂ 0.001), death from cardiac causes (p = 0.045), from stroke (p˂ 0.001), as well as the total number of adverse events (p˂ 0.001) and disability (p = 0.065). Indications for reconstructive surgery on the lower extremities arteries (LEA), and operations frequency were comparatible in groups. Amputation history, taking diuretics, presence of rhythm disturbances, and management by a surgeon increased the risk of adverse outcomes. Management by a cardiologist, reconstructive LEA surgeries, female sex improved the prognosis of patients.

Conclusion

Conclusion. Observation of PAD patients by a cardiologist contributes to a higher frequency of optimal drug therapy by patients and can reduce the number of adverse events in patients and improve their survival without affecting the timing and frequency of reconstructive LEA surgeries.

Highlights

Highlights. The study shows for the first time that during the three-year follow-up of patients with diseases of the arteries of the lower extremities in the observation groups of a general surgeon and a cardiologist, adverse events (myocardial infarction, stroke, amputation, disability) and deaths occurred more often in a surgeon than a cardiologist. The study proves the correctness and real benefit of such an approach with the involvement of a cardiologist to the outpatient stage of management of a complex cohort of patients with atherosclerosis of the vessels of the lower extremities.

Aim

Aim. To study the effect the outpatient observation of patients with peripheral arteries disease (PAD) by cardiologists and surgeons has on timing and prevalence of reconstructive surgery and the prognosis of patients. Methods We analyzed the data on 585 PAD patients who underwent outpatient observation from 2010 to 2017, dividing them into 2 groups. The first group (131 patients) managed by an surgeon; the second (454 patients) managed by a cardiologist. Since the groups were not comparable in terms of the initial parameters, the comparability of patients in the groups (observation by a surgeon or by a cardiologist) was achieved using pseudorandomization. The follow-up period was three years; we assessed the incidence of deaths, adverse events, and the prevalence of reconstructive operations.

Results

Results. During a three-year follow-up the 1st group, compared with the 2nd, had more deaths in general (p<0.001), death from cardiac causes (p = 0.045), from stroke (p><0.001), as well as the total number of adverse events (p><0.001) and disability (p = 0.065). Indications for reconstructive surgery on the lower extremities arteries (LEA), and operations frequency were comparatible in groups. Amputation history, taking diuretics, presence of rhythm disturbances, and management by a surgeon increased the risk of adverse outcomes. Management by a cardiologist, reconstructive LEA surgeries, female sex improved the prognosis of patients. Conclusion Observation of PAD patients by a cardiologist contributes to a higher frequency of optimal drug therapy by patients and can reduce the number of adverse events in patients and improve their survival without affecting the timing and frequency of reconstructive LEA surgeries. Keywords Peripheral atherosclerosis • Outpatient follow-up • Optimal drug therapy • Reconstructive surgery>˂ 0.001), death from cardiac causes (p = 0.045), from stroke (p˂ 0.001), as well as the total number of adverse events (p˂ 0.001) and disability (p = 0.065). Indications for reconstructive surgery on the lower extremities arteries (LEA), and operations frequency were comparatible in groups. Amputation history, taking diuretics, presence of rhythm disturbances, and management by a surgeon increased the risk of adverse outcomes. Management by a cardiologist, reconstructive LEA surgeries, female sex improved the prognosis of patients.

Conclusion

Conclusion. Observation of PAD patients by a cardiologist contributes to a higher frequency of optimal drug therapy by patients and can reduce the number of adverse events in patients and improve their survival without affecting the timing and frequency of reconstructive LEA surgeries.

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The authors declare that there are no conflicts of interest present.