While peripheral artery disease (PAD) was linked to an elevated risk of cardiovascular morbidity, mortality remained high and difficult to forecast; a precise assessment of serial PAD-specific health status around the time of diagnosis may help predict long-term mortality risk. Patients with new or worsening PAD symptoms who registered in the PORTRAIT Registry at 10 US sites between 2011 and 2015 were included in the research. The Peripheral Artery Questionnaire (PAQ) Summary score was used to measure health status at baseline, 3 months, and the change from baseline to 3 months follow-up. The association of the PAQ with 5-year all-cause mortality was assessed using Kaplan-Meier with a 3-month landmark and hierarchical Cox regression models. Over a median follow-up of 4.1 years, 141 (19.8%) of the 711 patients (mean age 68.8±9.6 years, 40.9% female, 72.7% white; mean PAQ 47.5±22.0 and 65.9±25.0 at baseline and 3 months, respectively) died. Baseline (HR, 0.90 per 10 point increment; 95% CI, 0.84–0.97; P=0.008), 3 month (HR [95% CI], 0.87 [0.82–0.93]; P<0.001), and change in PAQ (HR [95% CI], 0.92 [0.85–0.99]; P=0.021) were all linked to death in unadjusted models. 3-month PAQ was more strongly linked with mortality in fully adjusted models using a combination of scores than either baseline (3‐month HR [95% CI], 0.85 [0.78–0.92]; P<0.001; C‐statistic, 0.77) or change (3‐month HR [95% CI], 0.79 [0.72–0.87]; P<0.001). In patients with new or worsening PAD symptoms, PAD-specific health status was independently related to 5-year survival, with the most recent assessment being the most predictive. More research was needed to understand better how this data might have been used to optimize care in the future.
Link:www.ahajournals.org/doi/10.1161/JAHA.121.022232
