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Improvement in PAD health status linked with long-term survival after endovascular therapy
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After successful endovascular therapy for symptomatic peripheral artery disease, improvement in peripheral artery disease-specific health status at 1-year follow-up was associated with improved long-term survival, according to recent study results.
Researchers evaluated the link between health status and long-term survival after endovascular therapy in a cohort of 258 patients with symptomatic PAD enrolled in the prospective, single-center ALEVE study. The mean age at study enrollment was 68 years, 61% were men, 97% were white and 38% had diabetes.
The 20-item Peripheral Artery Questionnaire (PAQ) was used to gauge PAD-specific health status. At baseline and 1 year, patients responded to questions about PAD-related function, symptoms and quality of life. On this questionnaire, higher scores indicate better health status.
After endovascular therapy, patients were classified as responders or nonresponders. Responders demonstrated clinically meaningful improvement in health status at 1 year after the index endovascular procedure, as indicated by a PAQ score of 8 points or higher. Seventy-nine percent of patients in this study were classified as responders.
According to the results, 10-year survival was 60% among responders compared with 38% among nonresponders (P = .025). Responders also demonstrated better survival in risk-adjusted analyses; the adjusted HR for long-term mortality was 0.66 (95% CI, 0.45-0.97; P = .036).
According to the researchers, “the difference in long-term survival after endovascular therapy emerged by 2 to 3 years after endovascular therapy and persisted throughout the remainder of follow-up.”
Responders had a median survival that was approximately 2.5 years longer than that of the nonresponders (10.6 years vs. 7.9 years; P = .025).
“Although the precise mechanism of this association remains uncertain, these findings suggest that patients with poor response to endovascular therapy may be candidates for more intense follow-up and alternative treatment options in an attempt to improve long-term clinical outcomes,” the researchers concluded.
Disclosure: One researcher reports receiving research support from AstraZeneca; a second researcher reports receiving research support from Merck; and a third researcher reports consulting and receiving research support from Abbott Vascular, AstraZeneca, Boston Scientific, Eli Lilly, Medtronic and Merck, and speaking fees from AstraZeneca and Eli Lilly.
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