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Vascular Complications in Patients Undergoing Peripheral Revascularization and Taking SGLT-2 Inhibitors

Recruiting
Conditions
Peripheral Arterial Disease(PAD)
Interventions
Drug: Treatment with SGLT2 inhibitors (flozins)
Registration Number
NCT07157475
Lead Sponsor
Wroclaw Medical University
Brief Summary

The study is observational and involves patients (pts) with peripheral arterial occlusive disease (PAD) who have undergone lower limb revascularization procedures. Patients who are at least one year post-procedure will be contacted by phone and asked whether any cardiovascular complications occurred during that period, specifically major adverse cardiovascular events (MACE) or major adverse limb events (MALE), and whether they had been taking sodium-glucose co-transporter 2 inhibitors (SGLT2-i, "flozins") during the year following the procedure. The results from the group of pts who, for any reason, received SGLT2-i treatment after the vascular procedure (including those who had initiated treatment before surgery) will be compared to the results from the group of patients who did not receive such treatment, with regard to the occurrence of the aforementioned complications.

Detailed Description

Project Objective: To assess the impact of SGLT2 inhibitors (SGLT2-i) on vascular complications in patients undergoing peripheral revascularization.

Specific Objective: To evaluate the incidence of 3-point MACE\* (Major Adverse Cardiac Events) and MALE\*\* (Major Adverse Limb Events) following vascular surgical procedures (both open and minimally invasive), performed in patients treated with SGLT2- i vs controls ( non-treated pts).

Observation Period: One year - assessment at 30 days, 3 months, and 1 year post-procedure.

Definitions for:

\* MACE = Non-fatal myocardial infarction (MI),Non-fatal stroke involving the central nervous system (CNS), Cardiovascular death

\*\* MALE = Untreated restenosis or deterioration in patency of a previously revascularized vessel , Reintervention in the revascularized segment due to impaired patency, Amputation (either above or below the knee) of the revascularized limb.

Demographic and clinical data will be obtained from the medical records of patients hospitalized in three vascular surgery departments (Wrocław, Poznań, Warsaw), while information regarding MACE , MALE, and the use of SGLT2-i will be collected via telephone interviews with the patients (or their family members, if the patient is deceased).

The number of MACE and MALE incidents during the year following the procedure will be compared between the two groups.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
300
Inclusion Criteria
  • Peripheral vascular procedure ( Conventional surgical procedure or minimally invasive procedure) due to acute or chronic ischemia
  • Use of SGLT2 inhibitors (applies only to the group exposed to flozins) for at least 3 months prior to the vascular procedure (the indication for initiating the drug is irrelevant: chronic kidney disease [CKD] / cardiac reasons / diabetes), or immediately after the vascular procedure
  • Ability to determine the patient's outcomes within a minimum of 30 days up to 1 year following the vascular procedure
Exclusion Criteria
  • Vascular injury as the reason for the procedure
  • Amputation due to causes other than ischemia (e.g., cancer, neuropathy, trauma without coexisting ischemia)
  • Planned revascularization procedure other than for the lower limbs at the time of hospital discharge (e.g., coronary or carotid arteries)
  • Planned ischemia-related amputation or reoperation of the operated limb at the time of hospital discharge
  • Planned other major surgical procedure with high cardiovascular risk at the time of hospital discharge

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Patients after vascular surgery treated with flozinsTreatment with SGLT2 inhibitors (flozins)Patients aged ≥18 years who have undergone vascular surgery (either open or minimally invasive procedures) and, for any reason, were treated with SGLT2 inhibitors ("flozins") during the one-year follow-up period after the procedure.
Primary Outcome Measures
NameTimeMethod
MACE (Major Adverse Cardiovascular Events) and MALE (Major Adverse Limb Events)-Number of Participants Experiencing MACEor MALE12 months from the vascular intervention

MACE is defined as a composite of : Non-fatal myocardial infarction (MI); Non-fatal stroke involving the central nervous system (CNS); or Cardiovascular death MALE is defined as a composite of : Untreated loss or deterioration of patency in a previously revascularized vessel; Repeat intervention in a revascularized segment due to impaired patency, or Amputation (above or below the knee) of the revascularized limb Unit of Measure: Number of participants with at least one event

Secondary Outcome Measures
NameTimeMethod
Non-fatal Myocardial Infarction (MI)12 months from the vascular intervention

Non-fatal myocardial infarction (MI), Unit of Measure: Number of participants

Non-fatal stroke involving the central nervous system (CNS)

Cardiovascular death

Untreated loss or deterioration of patency in a previously revascularized vessel

Repeat intervention in a revascularized segment due to impaired patency

Amputation (above or below the knee) of the revascularized limb

Non-fatal Stroke Involving the Central Nervous System (CNS)12 months from the vascular intervention

Non-fatal Stroke Involving the Central Nervous System (CNS), Unit of Measure: Number of participants

Cardiovascular Death12 months from the vascular intervention

Cardiovascular Death, Unit of Measure: Number of participants

Loss or Deterioration of Patency in a Previously Revascularized Vessel12 months from the vascular intervention

Loss or Deterioration of Patency in a Previously Revascularized Vessel, Unit of Measure: Number of participants

Repeat intervention in a revascularized segment due to impaired patency12 months from the vascular intervention

Repeat intervention in a revascularized segment due to impaired patency; Unit of Measure: Number of participants and number of limbs

Amputation of the revascularized limb12 months from the vascular intervention

Amputation (above or below the knee) of the revascularized limb; Unit of Measure: Number of participants and number of limbs

Trial Locations

Locations (1)

Wroclaw Medical University

🇵🇱

Wroclaw, Lower Silesian Voivodeship, Poland

Wroclaw Medical University
🇵🇱Wroclaw, Lower Silesian Voivodeship, Poland
Edyta Sutkowska, M.D., PH.D.
Contact
48503077016
edyta.sutkowska@umw.edu.pl

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