Evaluation of atria risk score of patients with peripheral artery disease in terms of endpoints

Objective: In this study, we aimed to test the association of the ATRIA risk score with adverse outcomes and its predictive value in patients with severe peripheral arterial disease. Method: We planned a single-center, retrospective study. We retrospectively screened 911 patients who underwent peripheral arterial imaging at our hospital between January 2013 and January 2019. We included 305 patients with severe peripheral arterial disease who met the inclusion criteria in our study. The records and follow-up data of these patients were examined in detail. Data on mortality and limb loss during the 5-year follow-up were analyzed. Results: Limb loss occurred in 22 patients, and mortality of any cause occurred in 130 patients. When both endpoints were evaluated together, major adverse cardiovascular events (MACE) were observed in 138 patients. When examining the 5-year mortality data, the ATRIA score was found to be significantly higher in the mortality group compared to the non-mortality group (median value of 4.74 vs. 2.23, p<0.001). Additionally, the ATRIA score was significantly higher in the limb loss group during the 5-year follow-up (median value of 5.55 vs. 3.09, p<0.001). Furthermore, in the analysis of the MACE groups, which included total mortality and limb loss, the median ATRIA score was significantly higher in the MACE group compared to the non-MACE group (median value of 4.78 vs. 2.60, p<0.001). Advanced age, low GFR, low hemoglobin levels, low lymphocyte count, and the ATRIA score were identified as independent predictors of the development of 5-year MACE. Conclusion: Our study demonstrated that the ATRIA risk score is useful in predicting adverse outcomes such as mortality and limb loss in symptomatic patients with peripheral arterial disease. Patients with a higher ATRIA score experienced more limb loss and mortality. By using the ATRIA risk score, it may be possible to predict high-risk patients and implement more intensive measures such as lifestyle changes, optimal medical treatment, and, if necessary, early revascularization to reduce patient mortality and morbidity. Keywords: Peripheral arterial disease, ATRIA score, Claudication, Critical Limb Ischemia, MACE.