Absence of preceding intermittent claudication and its associated clinical freatures in patients with critical limb ischemia

Aim: the current study investigated how prevalent the absence of a prior history of intermittent claudication would be in patients with critical limb ischemia (cli) and examined the associated clinical features. methods: we used a database of 559 japanese cli patients participating in a multicenter prospective study. a history of intermittent claudication prior to cli onset was surveyed at registration. the 95% confidence interval (ci) of its prevalence was calculated using the clopper-pearson method. logistic regression analysis was performed to assess the association between the clinical features and the absence of preceding intermittent claudication. results: the study subjects were 73 ± 10 years old and 67% were male. tissue loss occurred in 82% of this population. the prevalence of the absence of prior intermittent claudication was 50% [95% ci: 46-55%]. in multivariate logistic regression analysis,a non-ambulatory status,diabetes mellitus,and regular dialysis were significantly and independently associated with the lack of a prior history of intermittent claudication (all p <0.05). indeed,the presence of these features was associated with a higher prevalence of the lack of the history. regular dialysis,but not non-ambulatory status or diabetes mellitus,lost its statistical significance after further adjustment for the presence of isolated infrap-opliteal lesions,whereas the presence of isolated infrapopliteal lesions itself was significantly associated with a lack of prior intermittent claudication. conclusions: the absence of a prior history of intermittent claudication was prevalent in cli patients. patients with a non-ambulatory status,diabetes mellitus,and regular dialysis were more likely to lack a prior history of intermittent claudication. © 2015,japan atherosclerosis society. all rights reserved.