Decreased peripheral perfusion measured by perfusion index is a novel indicator for cardiovascular death in patients with type 2 diabetes and established cardiovascular disease
Cardiovascular disease (CVD) is still the major cause of mortality in patients with type 2 diabetes. Despite of recent therapies, mortality and resources spent on healthcare due to CVD is still important problem.
Thus, appropriate markers are needed to predict poor outcomes. Therefore, we investigated the role of peripheral perfusion as an indicator for cardiovascular death in patients with type 2 diabetes and established CVD.
This retrospective cohort study included 1080 patients with type 2 diabetes and history of CVD recruited from the outpatient clinic at Matsushita Memorial Hospital in Osaka, Japan.
Peripheral perfusion is assessed using the perfusion index (PI), which represents the level of circulation through peripheral tissues.
The median age and PI values were 74 years (range: 67–79 years) and 2.6% (range: 1.1–4.3%), respectively.
During follow-up duration, 60 patients died due to CVD.
The adjusted Cox regression analysis demonstrated that the risk of developing cardiovascular death was higher in the first quartile (Hazard ratio, 6.23; 95% CI, 2.28 to 22.12) or second quartile (Hazard ratio, 3.04; 95% CI, 1.46 to 6.85) of PI than that in the highest quartile (fourth quartile) of PI.
PI (per 1% decrease) was associated with the development of cardiovascular death
(Hazard ratio, 1.39; 95% CI, 1.16 to 1.68).
PI could be a novel indicator of cardiovascular death in patients with type 2 diabetes and established CVD.
Sixty patients died due to cardiovascular death during study period
(Quartile 1, 2, 3 and 4; 32,14,10 and 4, respectively).
Cardiovascular death included 11 myocardial infarction, 44 heart failure, and 5 stroke during study period.
One hundred and ninety-six patients developed the recurrent cardiovascular events during study period
(Quartile 1,2,3 and 4; 86, 48, 37 and 25, respectively).
Four patients developed myocardial infarction, 16 patients developed stroke, 120 patients received revascularization for angina and 56 patients received revascularization for peripheral artery disease (PAD).