Patients with peripheral artery disease (PAD) have a high risk of future cardiovascular disease (CVD) events and mortality. Little is known about the changes in symptom classification over time in patients with PAD and the association of symptom classification changes with subsequent CVD events. In this analysis of the EUCLID trial, the changes in Rutherford classification (RC) of patients were examined over the course of 12 months.
Among 12,759 patients, 25% were classified as improved by RC at 12 months, 64% as no change and 11% as worsened. Patients who worsened over 12 months were more likely to have more events (major bleeding, amputation, and myocardial infarction) and comorbidities (prior myocardial infarction and diabetes mellitus). Worsened symptom classification was associated with increased risk of all-cause death, major amputation, and a composite of cardiovascular death, myocardial infarction, or stroke post-randomization.
In conclusion, patients with comorbidities and prior history of CVD events at baseline and within the first 12 months of the trial were more likely to have worsened symptom classification at 12 months. Worsening symptom classification over 12 months was associated subsequently with an increased risk of stroke, myocardial infarction, amputation, cardiovascular and all-cause death.
Ref: https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.120.009326
