Association of Disease‐Specific Health Status With Long‐Term Survival in Peripheral Artery Disease
Background While peripheral artery disease (PAD) is associated with increased cardiovascular morbidity with mortality remaining high and challenging to predict, accurate understanding of serial PAD‐specific health status around the time of diagnosis may prognosticate long‐term mortality risk. Method...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.022232 |
| _version_ | 1797859014929809408 |
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| author | Andy T. Tran John A. Spertus Carlos I. Mena‐Hurtado Philip G. Jones Herbert D. Aronow David M. Safley Ali O. Malik Poghni A. Peri‐Okonny Mehdi H. Shishehbor Clementine Labrosciano Kim G. Smolderen |
| author_facet | Andy T. Tran John A. Spertus Carlos I. Mena‐Hurtado Philip G. Jones Herbert D. Aronow David M. Safley Ali O. Malik Poghni A. Peri‐Okonny Mehdi H. Shishehbor Clementine Labrosciano Kim G. Smolderen |
| author_sort | Andy T. Tran |
| collection | DOAJ |
| description | Background While peripheral artery disease (PAD) is associated with increased cardiovascular morbidity with mortality remaining high and challenging to predict, accurate understanding of serial PAD‐specific health status around the time of diagnosis may prognosticate long‐term mortality risk. Methods and Results Patients with new or worsening PAD symptoms enrolled in the PORTRAIT Registry across 10 US sites from 2011 to 2015 were included. Health status was assessed by the Peripheral Artery Questionnaire (PAQ) Summary score at baseline, 3‐month, and change from baseline to 3‐month follow‐up. Kaplan‐Meier using 3‐month landmark and hierarchical Cox regression models were constructed to assess the association of the PAQ with 5‐year all‐cause mortality. 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‐month, respectively), 141 (19.8%) died over a median follow‐up of 4.1 years. In unadjusted models, 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 each associated with mortality. In fully adjusted models including combination of scores, 3‐month PAQ was more strongly associated with mortality 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). Conclusions PAD‐specific health status is independently associated with 5‐year survival in patients with new or worsening PAD symptoms, with the most recent assessment being most prognostic. Future work is needed to better understand how this information can be used proactively to optimize care. |
| first_indexed | 2024-04-09T21:22:38Z |
| format | Article |
| id | doaj.art-5a137f8c597c41e4bf76e091d87b0cd4 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T21:22:38Z |
| publishDate | 2022-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-5a137f8c597c41e4bf76e091d87b0cd42023-03-28T04:20:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-02-0111410.1161/JAHA.121.022232Association of Disease‐Specific Health Status With Long‐Term Survival in Peripheral Artery DiseaseAndy T. Tran0John A. Spertus1Carlos I. Mena‐Hurtado2Philip G. Jones3Herbert D. Aronow4David M. Safley5Ali O. Malik6Poghni A. Peri‐Okonny7Mehdi H. Shishehbor8Clementine Labrosciano9Kim G. Smolderen10Department of Medicine University of California Irvine School of Medicine Orange CACardiovascular Research Saint Luke’s Mid America Heart Institute Kansas City MOVascular Medicine Outcomes Program Section of Cardiovascular Medicine Department of Internal Medicine Yale University New Haven CTCardiovascular Research Saint Luke’s Mid America Heart Institute Kansas City MODepartment of Medicine Alpert Medical School of Brown University Providence RICardiovascular Research Saint Luke’s Mid America Heart Institute Kansas City MOCardiovascular Research Saint Luke’s Mid America Heart Institute Kansas City MOCardiovascular Research Saint Luke’s Mid America Heart Institute Kansas City MOInterventional Cardiovascular Center Case Western Reserve University School of Medicine Cleveland OHThe Queen Elizabeth Hospital Adelaide Medical School University of Adelaide SA AustraliaVascular Medicine Outcomes Program Section of Cardiovascular Medicine Department of Internal Medicine Yale University New Haven CTBackground While peripheral artery disease (PAD) is associated with increased cardiovascular morbidity with mortality remaining high and challenging to predict, accurate understanding of serial PAD‐specific health status around the time of diagnosis may prognosticate long‐term mortality risk. Methods and Results Patients with new or worsening PAD symptoms enrolled in the PORTRAIT Registry across 10 US sites from 2011 to 2015 were included. Health status was assessed by the Peripheral Artery Questionnaire (PAQ) Summary score at baseline, 3‐month, and change from baseline to 3‐month follow‐up. Kaplan‐Meier using 3‐month landmark and hierarchical Cox regression models were constructed to assess the association of the PAQ with 5‐year all‐cause mortality. 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‐month, respectively), 141 (19.8%) died over a median follow‐up of 4.1 years. In unadjusted models, 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 each associated with mortality. In fully adjusted models including combination of scores, 3‐month PAQ was more strongly associated with mortality 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). Conclusions PAD‐specific health status is independently associated with 5‐year survival in patients with new or worsening PAD symptoms, with the most recent assessment being most prognostic. Future work is needed to better understand how this information can be used proactively to optimize care.https://www.ahajournals.org/doi/10.1161/JAHA.121.022232health statusmortalityperipheral artery disease |
| spellingShingle | Andy T. Tran John A. Spertus Carlos I. Mena‐Hurtado Philip G. Jones Herbert D. Aronow David M. Safley Ali O. Malik Poghni A. Peri‐Okonny Mehdi H. Shishehbor Clementine Labrosciano Kim G. Smolderen Association of Disease‐Specific Health Status With Long‐Term Survival in Peripheral Artery Disease Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease health status mortality peripheral artery disease |
| title | Association of Disease‐Specific Health Status With Long‐Term Survival in Peripheral Artery Disease |
| title_full | Association of Disease‐Specific Health Status With Long‐Term Survival in Peripheral Artery Disease |
| title_fullStr | Association of Disease‐Specific Health Status With Long‐Term Survival in Peripheral Artery Disease |
| title_full_unstemmed | Association of Disease‐Specific Health Status With Long‐Term Survival in Peripheral Artery Disease |
| title_short | Association of Disease‐Specific Health Status With Long‐Term Survival in Peripheral Artery Disease |
| title_sort | association of disease specific health status with long term survival in peripheral artery disease |
| topic | health status mortality peripheral artery disease |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.022232 |
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