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Gender-related differences in critical limb ischemia due to peripheral arterial occlusive disease

BACKGROUND:

Mortality from cardiovascular disease has declined among men and increased among North American women. Recent studies have revealed differences between genders in the epidemiology of atherosclerotic disease.

OBJECTIVE:

To study possible differences between male and female patients with critical limb ischemia (CLI) according to risk factors of atherosclerosis and clinical characteristics of lower limbs with peripheral arterial occlusive disease (PAOD).

METHODS:

The study included 171 male and female patients treated for CLI due to infrainguinal PAOD and compared clinical characteristics (Rutherford category and PAOD territory), risk factors for atherosclerosis (diabetes, age, smoking and hypertension) and number of opacified arteries on digital angiograms of the leg. The EPI-INFO software was used for statistical analysis, and the level of significance was set at p<0.05.

RESULTS:

Mean age was 70 years, and 88 patients were men (52%). For most patients (both genders), Rutherford category was 5 (82 % of men and 70% of women; p=0.16). The group of women had higher mean age (73 vs. 67 years; p=0.0002) and greater prevalence of diabetes (66% vs. 45%; p=0.003) and hypertension (90% vs. 56%; p=0.0000001). Among men, the prevalence of smoking was higher (76% vs. 53%; p=0.0008). The analysis of digital angiograms revealed that opacification of only one artery in the leg was found for 74% of women (vs. 50% of men).

CONCLUSION:

The prevalence of risk factors for atherosclerosis and the characteristics of PAOD are different between male and female patients with CLI.

gender; atherosclerosis; ischemia; peripheral arterial disease


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