Abstract 10181: Impact of Modified H2FPEF Score on Chronic Limb Threatening Ischemia in Patients with Lower Extremity Artery Disease Who Underwent Endovascular Therapy

Introduction: Lower extremity artery disease (LEAD) is an arterial occlusive disease characterized by an insufficient blood supply to the lower limb arteries. The H2FPEF score, calculated using simple clinical characteristics and echocardiographic findings, has been developed to identify patients at high risk for heart failure (HF) with preserved ejection fraction. Purpose: This study aimed to assess the impact of modified H2FPEF scores on chronic limb-threatening ischemia (CLTI) in patients with LEAD. Methods: Since the definition of obesity differs by race, we calculated the modified H2FPEF score using a body mass index > 25 kg/m2 in 293 patients with LEAD who underwent their first endovascular therapy. Patients were retrospectively followed for a median follow-up period of 718 days. The primary and secondary endpoints were newly developed CLTI and composite events, including mortality due to worsening HF or rehospitalization in addition to CLTI, respectively. Results: The modified H2FPEF score significantly increased with advancing Fontaine classes. Kaplan-Meier analysis demonstrated that the highly modified H2FPEF score group (≥ 3) had a higher incidence of newly developed CLTI and composite events than the low H2FPEF score group (<3). Multivariate Cox proportional hazard analysis revealed that the modified H2FPEF score was an independent predictor of newly developed CLTI and composite events after adjustment for confounding risk factors. The net reclassification index and integrated discrimination improvement were significantly improved by adding the modified H2FPEF score to the basic predictors. Conclusions: The modified H2FPEF score was associated with LEAD severity and future CLTI development, suggesting that it could be a feasible marker for patients with LEAD.