Declining Walking Impairment Questionnaire Scores Are Associated With Subsequent Increased Mortality in Peripheral Artery Disease

作者:Jain Atul; Liu Kiang; Ferrucci Luigi; Criqui Michael H; Tian Lu; Guralnik Jack M; Tao Huimin; McDermott Mary M*
来源:Journal of the American College of Cardiology, 2013, 61(17): 1820-1829.
DOI:10.1016/j.jacc.2013.01.060

摘要

Objectives This study determined whether greater 2-year declines in Walking Impairment Questionnaire (WIQ) stair climbing, distance, or speed scores were associated with higher all-cause and cardiovascular disease (CVD) mortality among men and women with lower extremity peripheral artery disease (PAD). %26lt;br%26gt;Background Associations of decline in the WIQ with mortality among people with PAD are unknown. %26lt;br%26gt;Methods Participants were 442 men and women with PAD identified from Chicago area medical centers. The WIQ was completed at baseline and at 2-year follow-up. Cox proportional hazard models were used to assess associations across categories of 2-year changes in WIQ stair climbing, WIQ distance, and WIQ speed scores with subsequent all-cause and CVD mortality, adjusting for age, sex, race, ankle-brachial index, body mass index, smoking, comorbidities, and other covariates. %26lt;br%26gt;Results One hundred twenty-three participants (27.8%) died during a median follow-up of 4.7 years after the 2-year change in WIQ score measurements. Forty-five participants died from CVD. Adjusting for covariates, participants with WIQ score declines %26gt;= 20.0 points had higher all-cause mortality (hazard ratio [HR]: 1.93, 95% confidence interval [CI]: 1.01 to 3.68 for WIQ stair climbing; HR: 2.34, 95% CI: 1.15 to 4.75 for WIQ distance; and HR: 3.55, 95% CI: 1.57 to 8.04 for WIQ speed, respectively) compared with participants with %26gt;= 20.0 point improvement in each of the corresponding WIQ categories. Participants with %26gt;= 20.0 point declines in the WIQ distance score had higher CVD mortality (HR: 4.56, 95% CI: 1.30 to 16.01) compared with those with %26gt;= 20.0 point improvement in the WIQ distance score. %26lt;br%26gt;Conclusions Patients with PAD who experienced %26gt;= 20.0 point declines in the WIQ stair climbing, distance, and speed scores had a higher rate of all-cause mortality compared with those with less declines in each WIQ score.