{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T04:03:20Z","timestamp":1793160200958,"version":"4.5.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Epidemiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite advances in treatment, mortality in patients with chronic limb-threatening ischemia (CLTI) is high. The aim of our study was to evaluate 5-year all-cause mortality and factors associated with it in endovascularly treated (EVT) patients with foot ischemic ulcers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed all patients who had undergone EVT for lower extremity peripheral artery disease between January 2016 and December 2018. Adjustments in multivariate analyses were performed for age, hypertension, diabetes mellitus, sex, smoking, dyslipidemia, chronic obstructive pulmonary disease, malignancy, atrial fibrillation, heart failure with reduced ejection fraction, coronary artery disease, postprocedural ipsilateral amputation, ipsilateral reintervention, number of endovascularly treated regions, fibrinogen and creatinine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Four hundred and fifty-one patients (155 women, 296 men) with a mean age of 70.4\u2009\u00b1\u20099.60 years were included in the analysis. The 5-year all-cause mortality was 60.5%. In multivariate analysis mortality risk was higher in women (HR 1.42; 95% CI 1.09\u20131.86;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), and after EVT in two or more anatomical regions (HR 1.37; 95% CI 1.05\u20131.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022). The mortality risk was positively associated with creatinine (HR 1.003; 95% CI 1.002\u20131.004;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and fibrinogen (HR 1.19; 95% CI 1.11\u20131.29;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Ipsilateral reintervention (HR 0.67; 95%CI 0.47\u20130.94;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021) and ipsilateral amputation after EVT (HR 0.71; 95% CI 0.51\u20130.98;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037) were associated with lower all-cause mortality risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Female sex, treatment in two or more anatomical regions, creatinine and fibrinogen were associated with higher 5-year mortality risk. Lower 5-year all-cause mortality risk was observed in patients with ipsilateral reintervention and ipsilateral amputation after EVT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fepid.2026.1702848","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:54:30Z","timestamp":1769064870000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors associated with all-cause mortality in endovascularly treated patients with chronic limb-threatening ischemia"],"prefix":"10.3389","volume":"6","author":[{"given":"M\u00e1ria","family":"Ra\u0161iov\u00e1","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Pavl\u00edkov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Hud\u00e1k","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor","family":"Ko\u017e\u00e1r","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Dekanov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"655","DOI":"10.23736\/S0021-9509.18.10572-6","article-title":"BAD Transmission and SAD distribution: a new scenario for critical limb ischemia","volume":"59","author":"Ferraresi","year":"2018","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.ejvs.2019.05.006","article-title":"Global vascular guidelines on the management of chronic limb-threatening ischemia","volume":"58","author":"Conte","year":"2019","journal-title":"Eur J Vasc Endovasc"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1016\/S0140-6736(13)61249-0","article-title":"Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis","volume":"382","author":"Fowkes","year":"2013","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e034477","DOI":"10.1161\/JAHA.124.034477","article-title":"Long-Term mortality predictors using a machine-learning approach in patients with chronic limb-threatening ischemia after peripheral vascular intervention","volume":"13","author":"Callegari","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"B5","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s13047-020-00383-2","article-title":"Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer","volume":"13","author":"Armstrong","year":"2020","journal-title":"J Foot Ankle Res"},{"key":"B6","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1186\/s12933-016-0446-x","article-title":"Presentations of major peripheral arterial disease and risk of major outcomes in patients with type 2 diabetes: results from the ADVANCE-ON study","volume":"15","author":"Mohammedi","year":"2016","journal-title":"Cardiovasc Diabetol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1016\/j.jcin.2017.12.012","article-title":"Disease burden and clinical outcomes following initial diagnosis of critical limb ischemia in the medicare population","volume":"11","author":"Mustapha","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"key":"B8","doi-asserted-by":"publisher","first-page":"6081","DOI":"10.3390\/jcm12186081","article-title":"Limb salvage and survival in chronic limb-threatening ischemia: the need for a fast-track team-based approach","volume":"12","author":"Ventoruzzo","year":"2023","journal-title":"J Clin Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1161\/CIRCULATIONAHA.123.067687","article-title":"Illness trajectories after revascularization in patients with peripheral artery disease: a unified approach to understanding the risk of Major amputation and death","volume":"150","author":"Li","year":"2024","journal-title":"Circulation"},{"key":"B10","doi-asserted-by":"publisher","first-page":"17085381251379804","DOI":"10.1177\/17085381251379804","article-title":"Prediction of all-cause mortality in endovascularly treated patients with peripheral arterial disease of the lower extremities","volume":"13","author":"Pavl\u00edkov\u00e1","year":"2025","journal-title":"Vascular"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1093\/eurheartj\/ehac016","article-title":"Sex-related differences in treatment and outcome of chronic limb-threatening ischaemia: a real-world cohort","volume":"43","author":"Makowski","year":"2022","journal-title":"Eur Heart J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"477","DOI":"10.5551\/jat.57711","article-title":"Risk stratification for 2-year mortality in patients with chronic limb-threatening ischemia undergoing endovascular therapy","volume":"28","author":"Hata","year":"2021","journal-title":"J Atheroscler Thromb"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e009459","DOI":"10.1161\/CIRCINTERVENTIONS.120.009459","article-title":"Sex differences in management and outcomes of critical limb ischemia in the medicare population","volume":"13","author":"Mentias","year":"2020","journal-title":"Circ Cardiovasc Interv"},{"key":"B14","doi-asserted-by":"publisher","first-page":"316","DOI":"10.3390\/jpm13020316","article-title":"Sex-Related differences and factors associated with peri-procedural and 1 year mortality in chronic limb-threatening ischemia patients from the CLIMATE Italian registry","volume":"13","author":"Martelli","year":"2023","journal-title":"J Pers Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.12771\/emj.2024.e15","article-title":"Sex differences in coronary atherogenesis: a narrative review","volume":"47","author":"Kim","year":"2024","journal-title":"Ewha Med J"},{"key":"B16","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/s11883-018-0742-x","article-title":"Peripheral arterial disease in women: an overview of risk factor profile, clinical features, and outcomes","volume":"20","author":"Jelani","year":"2018","journal-title":"Curr Atheroscler Rep"},{"key":"B17","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.avsg.2023.03.007","article-title":"A systematic review and meta-analysis on sex-based disparities in patients with chronic limb threatening ischemia undergoing revascularization","volume":"95","author":"Farag","year":"2023","journal-title":"Ann Vasc Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.ejvs.2024.08.046","article-title":"Changes in sex related mortality after revascularisation for chronic lmb threatening ischaemia: a national observational study 1994\u20132018","volume":"69","author":"Skoog","year":"2025","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.jvs.2019.06.105","article-title":"Systematic review and meta-analysis of sex differences in outcomes after endovascular aneurysm repair for infrarenal abdominal aortic aneurysm","volume":"71","author":"Liu","year":"2020","journal-title":"J Vasc Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e017235","DOI":"10.1161\/JAHA.120.017235","article-title":"Sex differences in modifiable risk factors and severity of coronary artery disease","volume":"9","author":"Manfrini","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"B21","doi-asserted-by":"publisher","first-page":"467","DOI":"10.5551\/jat.ED138","article-title":"Two-year mortality in CLTI patients provide crucial factors we should fight","volume":"28","author":"Soga","year":"2021","journal-title":"J Atheroscler Thromb"},{"key":"B22","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.jvn.2023.11.011","article-title":"Making decisions about amputation for chronic limb threatening ischaemia","volume":"42","author":"Monaro","year":"2024","journal-title":"J Vasc Nurs"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.2147\/CIA.S137570","article-title":"Mortality after major amputation in elderly patients with critical limb ischemia","volume":"12","author":"Klaphake","year":"2017","journal-title":"Clin Interv Aging"},{"key":"B24","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1159\/000541146","article-title":"Outcomes of patients with critical limb ischemia and chronic kidney disease: a national perspective","volume":"14","author":"Rivera","year":"2024","journal-title":"Cardiorenal Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"3749","DOI":"10.2147\/IJGM.S322417","article-title":"The impact of chronic kidney disease on peripheral artery disease and peripheral revascularization","volume":"14","author":"Serra","year":"2021","journal-title":"Int J Gen Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1002\/ccd.31447","article-title":"Chronic kidney disease and risk of mortality and Major adverse limb events after femoral artery endovascular revascularization for peripheral artery disease: the Boston femoral artery endovascular revascularization outcomes (Boston FAROUT) study","volume":"105","author":"Evans","year":"2025","journal-title":"Catheter Cardiovasc Interv"},{"key":"B27","doi-asserted-by":"publisher","first-page":"11129","DOI":"10.1038\/s41598-019-47560-3","article-title":"Prognostic value of serum creatine level in patients with vulvar cancer","volume":"9","author":"Schwameis","year":"2019","journal-title":"Sci Rep"},{"key":"B28","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1016\/j.endinu.2019.12.008","article-title":"Should we pay more attention to low creatinine levels?","volume":"67","author":"Diago","year":"2020","journal-title":"Endocrinol Diabetes Nutr (Engl Ed)"},{"key":"B29","doi-asserted-by":"publisher","first-page":"798","DOI":"10.3390\/biomedicines12040798","article-title":"Narrative review of biological markers in chronic limb-threatening ischemia","volume":"12","author":"Popescu","year":"2024","journal-title":"Biomedicines"},{"key":"B30","doi-asserted-by":"publisher","first-page":"2050313X","DOI":"10.1177\/2050313X221149359","article-title":"Rheocarna\u00ae as an alternative therapeutic option for patients with chronic limb-threatening ischemia: a case report","volume":"11","author":"Satake","year":"2023","journal-title":"SAGE Open Med Case Rep"},{"key":"B31","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1177\/0003319717739720","article-title":"Raised fibrinogen levels and outcome in outpatients with peripheral artery disease","volume":"69","author":"Altes","year":"2018","journal-title":"Angiology"},{"key":"B32","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/S1078-5884(03)00340-X","article-title":"Fibrinogen predicts mortality in high risk patients with peripheral artery disease","volume":"26","author":"Doweik","year":"2003","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B33","doi-asserted-by":"publisher","first-page":"8608","DOI":"10.1038\/s41598-023-31527-6","article-title":"High fibrinogen levels are associated with poor survival in patients with liposarcoma","volume":"13","author":"Peschek","year":"2023","journal-title":"Sci Rep"},{"key":"B34","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.avsg.2023.11.028","article-title":"Rencuzogullari I. Predictive value of the Naples prognostic score on long-term outcomes in patients with peripheral artery disease revascularized via percutaneous intervention","volume":"102","author":"Artac","year":"2024","journal-title":"Ann Vasc Surg"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1097\/DCR.0000000000000961","article-title":"Naples Prognostic score, based on nutritional and inflammatory Status, is an independent predictor of long-term outcome in patients undergoing surgery for colorectal cancer","volume":"60","author":"Galizia","year":"2017","journal-title":"Dis Colon Rectum"}],"container-title":["Frontiers in Epidemiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fepid.2026.1702848\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:54:31Z","timestamp":1769064871000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fepid.2026.1702848\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,22]]},"references-count":35,"alternative-id":["10.3389\/fepid.2026.1702848"],"URL":"https:\/\/doi.org\/10.3389\/fepid.2026.1702848","relation":{},"ISSN":["2674-1199"],"issn-type":[{"value":"2674-1199","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,22]]},"article-number":"1702848"}}