C 2010, Wiley Periodicals, Inc. DOI: 10.1111/j.1540-8183.2010.00548.x PERIPHERAL VASCULAR INTERVENTION Predictors of Poor Outcome in Female Patients Undergoing Endovascular Intervention AMR E. ABBAS, M.D., F.A.C.C., LAURA M. GOODMAN, M.D., RYAN TIMMIS, and JUDITH BOURA, M.S. From the William Beaumont Hospital, Department ofCardiology, Royal Oak, Michigan Background: Peripheral arterial disease (PAD) is widely accepted as an independent predictor of cardiovascular morbidity and mortality. The majority of subjects studied in PAD literature have been male, leaving female patients an underrepresented population with regard to revascularization outcomes and prognosis. The purpose of our study was to determine predictors of poor outcomes in female patients undergoing endovascular intervention (EI) for symptomatic PAD. Methods: This study was conducted as a single-center retrospective chart review of 292 consecutive female patients who underwent EI for symptomatic PAD. Patient variables including baseline demographics, and procedural data were analyzed for statistical significance with regard to repeat EI including target vessel revascularization (TVR), amputation or vascular surgery, and death. Results: On multivariate analysis, increased preintervention creatinine ≥1.5 mg/dL (PRE-CR) and lower pre- procedure hemoglobin were the strongest predictors of subsequent EI and TVR. Significant predictors for am- putation or surgery included decreased body mass index (BMI) and increased Rutherford class at presen- tation. Only age, history of congestive heart failure (CHF), and PRE-CR remained significant predictors of mortality. Conclusions: Our study is the first of its kind to specify predictors of poor outcomes after EI in female patients with symptomatic PAD. The strongest predictors of subsequent EI and TVR, limb loss, and vascular surgery, as well as death, were found to be chronic kidney disease (CKD; PRE-CR > 1.5 mg/dL), decreased BMI, Rutherford class, and anemia. (J Interven Cardiol 2010;23:401–410) Introduction As a manifestation of systemic atherosclerosis, pe- ripheral arterial disease (PAD) is now widely accepted as an independent risk factor for cardiovascular mor- bidity and mortality. Individuals with PAD have an increased risk of heart disease, stroke, and limb loss, in addition to a decreased quality of life. 1,2 Though the majority of patients studied have been male, several studies have implied that female gender may be an in- dependent risk factor for adverse clinical outcomes in PAD. 3–7 Address for reprints: Amr E. Abbas, M.D., 27901 Woodward #300, Berkley, MI 48072-0921. Fax: 248-837-2521; e-mail: AAbbas@ beaumont.edu The prevalence of PAD among women has been re- ported to range between 3% and 29%, although these numbers may be greatly underestimated as the majority of female patients are asymptomatic. 1,2 Once claudi- cation symptoms are present, however, females have a twofold higher mortality rate compared with male PAD patients. 2 While aggressive risk factor modification and endovascular interventions (EI) have improved treatment outcomes, recent studies have suggested that female patients with PAD have lower patency rates fol- lowing iliac artery revascularization 3–5,8 and increased incidence of stent thrombosis. 4,5,7,8 The purpose of our study was to determine predictors of poor outcomes in female patients undergoing EI for symptomatic PAD. Vol. 23, No. 4, 2010 Journal of Interventional Cardiology 401