{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:58:33Z","timestamp":1792511913944,"version":"4.5.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The long-term life expectancy and fate of the leg, including progression rate to critical limb ischaemia (CLI), were analysed in de novo patients with intermittent claudication (IC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A prospective cohort study was performed in 1107 patients with de novo IC. The endpoints were overall survival (OS), freedom from major adverse cardiovascular events (MACE), freedom from major adverse cardiovascular and limb events (MACLE), and fate of the leg. The 5-, 10-, 15-, and 20-year rates were 73.3, 47.8, 28.1, and 14.9% for OS, and 63.0, 35.6, 18.5, and 5.7% for freedom from MACE, respectively. In Cox multivariable analysis, body mass index, diabetes, haemodialysis, and C-reactive protein (CRP) level were correlated with OS (P\u2009&amp;lt;\u20090.05). Ankle brachial pressure index, diabetes, coronary artery disease, haemodialysis, and CRP level were independently correlated with freedom from MACE and MACLE. Statins improved mortality, MACE, and MACLE (P\u2009&amp;lt;\u20090.05). Revascularization did not improve mortality and MACE, and femoropopliteal revascularization increased MACLE (P\u2009&amp;lt;\u20090.05). There was no deterioration of claudication in 881 patients (79.6%). Worsening claudication was noted in 211 patients (14.8% per 5 years), and 15 patients (1.1% per 5 years) worsened to CLI. Diabetes and haemodialysis were independent predictors of CLI. A history of cerebral infarction and femoropopliteal revascularization tended to increase CLI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Life expectancy in patients with IC was poor, but the rate of IC progression to CLI was low. Statins improved mortality and morbidity, revascularization did not improve mortality and MACE, and femoropopliteal revascularization reduced freedom from MACLE with a risk of CLI.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcw057","type":"journal-article","created":{"date-parts":[[2016,11,2]],"date-time":"2016-11-02T12:07:01Z","timestamp":1478088421000},"page":"208-215","source":"Crossref","is-referenced-by-count":55,"title":["Long-term survival and fate of the leg in <i>de novo<\/i> intermittent claudication"],"prefix":"10.1093","volume":"3","author":[{"given":"Hisao","family":"Kumakura","sequence":"first","affiliation":[{"name":"Department of Vascular Medicine, Vascular Center, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shimohakoda 740 Hokkitu-machi, Shibukawa, Gunma 377-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyoshi","family":"Kanai","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Vascular Center, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shimohakoda 740 Hokkitu-machi, Shibukawa, Gunma 377-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Hojo","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Vascular Center, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shimohakoda 740 Hokkitu-machi, Shibukawa, Gunma 377-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiya","family":"Iwasaki","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Vascular Center, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shimohakoda 740 Hokkitu-machi, Shibukawa, Gunma 377-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Ichikawa","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Vascular Center, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shimohakoda 740 Hokkitu-machi, Shibukawa, Gunma 377-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,11,8]]},"reference":[{"key":"2021011601343242000_qcw057-B1","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/j.jvs.2006.12.037","article-title":"Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)","volume":"45","author":"Norgren","year":"2007","journal-title":"J Vasc Surg"},{"key":"2021011601343242000_qcw057-B2","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1016\/j.jacc.2008.07.060","article-title":"Progression of peripheral arterial disease predicts cardiovascular disease morbidity and mortality","volume":"52","author":"Criqui","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"2021011601343242000_qcw057-B3","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jvs.2010.02.008","article-title":"The influence of the obesity paradox and chronic kidney disease on long-term survival in a Japanese cohort with peripheral arterial disease","volume":"52","author":"Kumakura","year":"2010","journal-title":"J Vasc Surg"},{"key":"2021011601343242000_qcw057-B4","doi-asserted-by":"crossref","first-page":"e463","DOI":"10.1161\/CIRCULATIONAHA.106.174526","article-title":"ACC\/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery\/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC\/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; 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