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Declines in walking impairment linked to greater mortality in patients with PAD
Men and women with peripheral artery disease who experience 2-year declines in Walking Impairment Questionnaire stair climbing, distance and speed scores appear to have a higher rate of all-cause mortality compared with those with less impairment.
Researchers at three Chicago-area vascular laboratories studied Walking Impairment Questionnaire scores of 442 men and women with PAD. The questionnaire was completed at baseline and 2 years later. The researchers used Cox proportional hazard models to assess associations across domains of Walking Impairment Questionnaire stair climbing, distance and speed scores with subsequent all-cause and CVD mortality, after adjustment for age, sex, race, ankle brachial index, BMI, smoking, comorbidities and other covariates.
During a median follow-up of 4.7 years, 123 participants (27.8%) died; 44 deaths were attributed to CVD.
Participants with Walking Impairment Questionnaire score declines of 20 points or more had a higher rate of all-cause mortality (HR=1.93; 95% CI, 1.01-3.68 for stair climbing; HR=2.34; 95% CI, 1.15-4.75 for distance; HR=3.55; 95% CI, 1.57-8.04 for speed) compared with participants with at least a 20-point improvement in each of the corresponding questionnaire categories. Participants with declines of 20 points or more in Walking Impairment Questionnaire distance score had a higher rate of CVD mortality (HR=4.56; 95% CI, 1.3-16.01) compared with participants with improvements in distance score.
“Men and women with peripheral artery disease with greater decline in Walking Impairment Questionnaire stair climbing, distance or speed scores are at higher all-cause mortality risk compared with those with greater improvements in Walking Impairment Questionnaire domain scores,” Atoll Jain, MD, from the department of medicine at the University of Chicago, and colleagues wrote in the study. “The progression of systemic CVD is a potential mechanism for increased all-cause mortality.”
Disclosure: The researchers report no relevant financial disclosures.