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Clinical Trial
. 2008 Apr 15;51(15):1482-9.
doi: 10.1016/j.jacc.2007.12.034.

Prognostic value of functional performance for mortality in patients with peripheral artery disease

Mary M McDermott  1 , Lu Tian, Kiang Liu, Jack M Guralnik, Luigi Ferrucci, Jin Tan, William H Pearce, Joseph R Schneider, Michael H Criqui
Affiliations
Clinical Trial

Prognostic value of functional performance for mortality in patients with peripheral artery disease

Mary M McDermott et al. J Am Coll Cardiol. .

Abstract

Objectives: Among persons with lower extremity peripheral artery disease (PAD), we determined whether objective measures of walking performance predict mortality independently of the ankle brachial index (ABI).

Background: The ability of office-based functional performance measures to predict mortality in patients with PAD is unknown.

Methods: Participants were 444 persons with PAD followed prospectively for 4.8 years. The 6-min walk and 4-m walks at usual and fastest pace were measured at baseline. Cox proportional hazard models were used to assess relations between baseline measures of lower extremity performance with mortality, adjusting for confounders.

Results: One hundred twenty-seven patients (28.6%) died during follow-up. Adjusting for age, gender, race, comorbidities, ABI, and other confounders, participants in the poorest baseline quartile of 6-min walk performance had significantly increased total mortality (hazard ratio [HR] 2.36 [95% confidence interval (CI) 1.33 to 4.18]) and cardiovascular mortality (HR 5.59 [95% CI 1.97 to 15.9]) compared with the best quartile of baseline performance. Participants in the poorest baseline quartile of normal-paced 4-m walking speed had significantly increased total mortality (HR 1.86 [95% CI 1.06 to 3.29]) and cardiovascular mortality (HR 2.55 [95% CI 1.01 to 6.46]) compared with the best quartile of baseline performance.

Conclusions: This study demonstrates for the first time that performance-based measures, which can be administered in an office setting, provide prognostic information regarding mortality in persons with PAD beyond that provided by the ABI.

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Conflict of interest statement

Conflicts of Interest. There are no conflicts of interest to report.

Figures

Figure 1
Figure 1. Total Mortality
Associations of functional performance with all-cause mortality among persons with peripheral arterial disease (N = 444). Model 1- Results of proportional hazards analyses adjusting for age and sex. Model 2- Results of proportional hazards analyses adjusting for age, sex, race, comorbidities (cardiovascular diseases, pulmonary disease, cancer, and diabetes), body mass index, cigarette smoking history, and the ankle brachial index.
Figure 2
Figure 2. Cardiovascular Disease Mortality
Associations of functional performance with cardiovascular disease mortality among persons with peripheral arterial disease (N = 444). Model 1- Results of proportional hazards analyses adjusting for age and sex. Model 2- Results of proportional hazards analyses adjusting for age, sex, race, comorbidities (cardiovascular diseases, pulmonary disease, cancer, and diabetes), body mass index, cigarette smoking history, and the ankle brachial index. Because of a small number of cardiovascular deaths in patients with short physical performance battery (SPPB) scores of 0–4, this category was combined with the category of participants with an SPPB of 5–8.
See this image and copyright information in PMC

References

    1. Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics-2007 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;115:e69–71. - PubMed
    1. Heald CL, Fowkes FG, Murray GD, Price JF Ankle-brachial index collaboration. Risk of mortality and cardiovascular disease associated with the ankle- brachial index: Systematic review. Atherosclerosis. 2006;189:61–9. - PubMed
    1. Sikkink CJ, van Asten WN, van’t Hof MA, van Langen H, van der Vliet JA. Decreased ankle/brachial indices in relation to morbidity and mortality in patients with peripheral arterial disease. Vasc Med. 1997;2:169–173. - PubMed
    1. McDermott MM, Greenland P, Liu K, et al. Leg symptoms commonly reported by men and women with lower extremity peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA. 2001;286:1599–1606. - PubMed
    1. McDermott MM, Greenland P, Liu K, et al. The ankle brachial index as a measure of leg functioning and physical activity in peripheral arterial disease: the walking and leg circulation study. Ann Intern Med. 2002;136:873–83. - PubMed

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