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The prognostic value of impaired walking distance on long-term outcome in patients with known or suspected peripheral arterial disease.
Eur J Vasc Endovasc Surg. 2009 Oct; 38(4):482-7.EJ

Abstract

OBJECTIVES

To assess the predictive value of walking distance after an exercise test on long-term outcome in patients with normal and impaired ankle-brachial index (ABI).

DESIGN

A total of 2191 patients with known or suspected peripheral arterial disease (PAD), who were referred for a single-stage treadmill exercise test to diagnose or evaluate their PAD, were enrolled in an observational study between 1993 and 2006.

MATERIALS AND METHODS

They were divided into two groups: normal ABI (>or=0.90) and impaired ABI (<0.90). Walking distance was divided into quartiles (no (reference), mild, moderate or severe impairment).

RESULTS

In patients with normal ABI, severe walking distance was, after adjustment, associated with higher mortality risk (hazard ratio (HR): 2.60 (range: 1.16-5.78)). In patients with impaired ABI, all walking distance impairment quartiles were associated with higher mortality (mild HR: 1.26 (range: 0.95-1.67), moderate HR: 1.52 (range: 1.13-2.05) and severe HR: 1.69 (range: 1.26-2.27)). Furthermore, comparable associations were observed between all walking distance quartiles, cardiac death or major adverse cerebrovascular and cardiac events.

CONCLUSIONS

Our study illustrated that walking impairment is a strong prognostic indicator of long-term outcome in patients with impaired and normal ABI, which should be a warning sign to physicians to monitor these patients carefully and to provide them optimal treatment.

Authors+Show Affiliations

Department of Anesthesiology, Erasmus MC, Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19586784

Citation

de Liefde, I I., et al. "The Prognostic Value of Impaired Walking Distance On Long-term Outcome in Patients With Known or Suspected Peripheral Arterial Disease." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 38, no. 4, 2009, pp. 482-7.
de Liefde II, Hoeks SE, van Gestel YR, et al. The prognostic value of impaired walking distance on long-term outcome in patients with known or suspected peripheral arterial disease. Eur J Vasc Endovasc Surg. 2009;38(4):482-7.
de Liefde, I. I., Hoeks, S. E., van Gestel, Y. R., Klein, J., Bax, J. J., Verhagen, H. J., van Domburg, R. T., & Poldermans, D. (2009). The prognostic value of impaired walking distance on long-term outcome in patients with known or suspected peripheral arterial disease. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 38(4), 482-7. https://doi.org/10.1016/j.ejvs.2009.02.022
de Liefde II, et al. The Prognostic Value of Impaired Walking Distance On Long-term Outcome in Patients With Known or Suspected Peripheral Arterial Disease. Eur J Vasc Endovasc Surg. 2009;38(4):482-7. PubMed PMID: 19586784.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The prognostic value of impaired walking distance on long-term outcome in patients with known or suspected peripheral arterial disease. AU - de Liefde,I I, AU - Hoeks,S E, AU - van Gestel,Y R B M, AU - Klein,J, AU - Bax,J J, AU - Verhagen,H J M, AU - van Domburg,R T, AU - Poldermans,D, Y1 - 2009/07/07/ PY - 2008/04/01/received PY - 2009/02/06/accepted PY - 2009/7/10/entrez PY - 2009/7/10/pubmed PY - 2009/9/25/medline SP - 482 EP - 7 JF - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery JO - Eur J Vasc Endovasc Surg VL - 38 IS - 4 N2 - OBJECTIVES: To assess the predictive value of walking distance after an exercise test on long-term outcome in patients with normal and impaired ankle-brachial index (ABI). DESIGN: A total of 2191 patients with known or suspected peripheral arterial disease (PAD), who were referred for a single-stage treadmill exercise test to diagnose or evaluate their PAD, were enrolled in an observational study between 1993 and 2006. MATERIALS AND METHODS: They were divided into two groups: normal ABI (>or=0.90) and impaired ABI (<0.90). Walking distance was divided into quartiles (no (reference), mild, moderate or severe impairment). RESULTS: In patients with normal ABI, severe walking distance was, after adjustment, associated with higher mortality risk (hazard ratio (HR): 2.60 (range: 1.16-5.78)). In patients with impaired ABI, all walking distance impairment quartiles were associated with higher mortality (mild HR: 1.26 (range: 0.95-1.67), moderate HR: 1.52 (range: 1.13-2.05) and severe HR: 1.69 (range: 1.26-2.27)). Furthermore, comparable associations were observed between all walking distance quartiles, cardiac death or major adverse cerebrovascular and cardiac events. CONCLUSIONS: Our study illustrated that walking impairment is a strong prognostic indicator of long-term outcome in patients with impaired and normal ABI, which should be a warning sign to physicians to monitor these patients carefully and to provide them optimal treatment. SN - 1532-2165 UR - https://www.unboundmedicine.com/medline/citation/19586784/The_prognostic_value_of_impaired_walking_distance_on_long_term_outcome_in_patients_with_known_or_suspected_peripheral_arterial_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-5884(09)00300-1 DB - PRIME DP - Unbound Medicine ER -