Arya S et al. – This study examined the effect of poor glycemic control indicated by high hemoglobin A1c (HbA1c) level on the risk of amputation and modified major adverse limb events (mMALEs) after lower extremity revascularization in patients with peripheral arterial disease (PAD). Poor glycemic control significantly increased the risk of amputation and mMALE with the risks increasing with incremental increase in HbA1c.

Methods

• This study identified PAD patients undergoing revascularization whose HbA1c levels were available within 6 months in the Veterans Affairs database of 2003 to 2014 (N = 26,799).

Results

• Higher HbA1c levels were present in 33.2% of patients and preoperative diabetes mellitus (PreopDM) in 59.9%.Amputation occurred in 16.3% of patients, and 39.5% had mMALE.
• Worst outcomes were observed in patients with PreopDM and high HbA1c levels.