Association between health status and long-term mortality after percutaneous revascularization of peripheral artery disease

Matthew C. Bunte, John A. House, John A. Spertus, David J. Cohen, Steven P. Marso, David M. Safley

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives To explore the association of health status change and long-term survival among patients with symptomatic peripheral artery disease (PAD). Background Early gains in health status after successful endovascular therapy (EVT) for symptomatic PAD can be maintained up to 1 year. Whether such health status improvements are associated with long-term survival benefits is unknown. Methods Between February 2001 and August 2004, 258 patients with symptomatic PAD treated with EVT participated in a prospective study evaluating baseline and 1 year health status using the Peripheral Artery Questionnaire (range 0-100, higher scores = better). All-cause mortality was assessed for all patients at a median of 9.4 years following EVT. Results The mean age at enrollment was 68 ± 11 years; 61% were male, 97% were Caucasian, and 38% had diabetes. Patients with a clinically meaningful health status improvement (≥8 points) 1 year after their index procedure (79%) were identified as responders. Responders had a significantly better 10 year survival compared with nonresponders (60% vs 38%, p = 0.025). Responder status was associated with a survival advantage that persisted in risk-adjusted analysis (adjusted hazard ratio for long-term mortality, 0.66 [95% CI, 0.45-0.97]; p = 0.036). Conclusions Among patients with symptomatic PAD undergoing EVT, improvement of PAD-specific health status at 1 year follow-up was associated with improved long-term survival. Whether additional treatment for patients with poor response to EVT could improve long-term survival warrants further investigation.

Original languageEnglish (US)
Pages (from-to)1149-1155
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume87
Issue number6
DOIs
StatePublished - May 1 2016

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Peripheral Arterial Disease
Health Status
Survival
Mortality
Therapeutics
Arteries
Prospective Studies

Keywords

  • angioplasty
  • peripheral artery disease
  • quality of life

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Association between health status and long-term mortality after percutaneous revascularization of peripheral artery disease. / Bunte, Matthew C.; House, John A.; Spertus, John A.; Cohen, David J.; Marso, Steven P.; Safley, David M.

In: Catheterization and Cardiovascular Interventions, Vol. 87, No. 6, 01.05.2016, p. 1149-1155.

Research output: Contribution to journalArticle

Bunte, Matthew C. ; House, John A. ; Spertus, John A. ; Cohen, David J. ; Marso, Steven P. ; Safley, David M. / Association between health status and long-term mortality after percutaneous revascularization of peripheral artery disease. In: Catheterization and Cardiovascular Interventions. 2016 ; Vol. 87, No. 6. pp. 1149-1155.
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abstract = "Objectives To explore the association of health status change and long-term survival among patients with symptomatic peripheral artery disease (PAD). Background Early gains in health status after successful endovascular therapy (EVT) for symptomatic PAD can be maintained up to 1 year. Whether such health status improvements are associated with long-term survival benefits is unknown. Methods Between February 2001 and August 2004, 258 patients with symptomatic PAD treated with EVT participated in a prospective study evaluating baseline and 1 year health status using the Peripheral Artery Questionnaire (range 0-100, higher scores = better). All-cause mortality was assessed for all patients at a median of 9.4 years following EVT. Results The mean age at enrollment was 68 {\^A}± 11 years; 61{\%} were male, 97{\%} were Caucasian, and 38{\%} had diabetes. Patients with a clinically meaningful health status improvement (≥8 points) 1 year after their index procedure (79{\%}) were identified as responders. Responders had a significantly better 10 year survival compared with nonresponders (60{\%} vs 38{\%}, p = 0.025). Responder status was associated with a survival advantage that persisted in risk-adjusted analysis (adjusted hazard ratio for long-term mortality, 0.66 [95{\%} CI, 0.45-0.97]; p = 0.036). Conclusions Among patients with symptomatic PAD undergoing EVT, improvement of PAD-specific health status at 1 year follow-up was associated with improved long-term survival. Whether additional treatment for patients with poor response to EVT could improve long-term survival warrants further investigation.",
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N2 - Objectives To explore the association of health status change and long-term survival among patients with symptomatic peripheral artery disease (PAD). Background Early gains in health status after successful endovascular therapy (EVT) for symptomatic PAD can be maintained up to 1 year. Whether such health status improvements are associated with long-term survival benefits is unknown. Methods Between February 2001 and August 2004, 258 patients with symptomatic PAD treated with EVT participated in a prospective study evaluating baseline and 1 year health status using the Peripheral Artery Questionnaire (range 0-100, higher scores = better). All-cause mortality was assessed for all patients at a median of 9.4 years following EVT. Results The mean age at enrollment was 68 ± 11 years; 61% were male, 97% were Caucasian, and 38% had diabetes. Patients with a clinically meaningful health status improvement (≥8 points) 1 year after their index procedure (79%) were identified as responders. Responders had a significantly better 10 year survival compared with nonresponders (60% vs 38%, p = 0.025). Responder status was associated with a survival advantage that persisted in risk-adjusted analysis (adjusted hazard ratio for long-term mortality, 0.66 [95% CI, 0.45-0.97]; p = 0.036). Conclusions Among patients with symptomatic PAD undergoing EVT, improvement of PAD-specific health status at 1 year follow-up was associated with improved long-term survival. Whether additional treatment for patients with poor response to EVT could improve long-term survival warrants further investigation.

AB - Objectives To explore the association of health status change and long-term survival among patients with symptomatic peripheral artery disease (PAD). Background Early gains in health status after successful endovascular therapy (EVT) for symptomatic PAD can be maintained up to 1 year. Whether such health status improvements are associated with long-term survival benefits is unknown. Methods Between February 2001 and August 2004, 258 patients with symptomatic PAD treated with EVT participated in a prospective study evaluating baseline and 1 year health status using the Peripheral Artery Questionnaire (range 0-100, higher scores = better). All-cause mortality was assessed for all patients at a median of 9.4 years following EVT. Results The mean age at enrollment was 68 ± 11 years; 61% were male, 97% were Caucasian, and 38% had diabetes. Patients with a clinically meaningful health status improvement (≥8 points) 1 year after their index procedure (79%) were identified as responders. Responders had a significantly better 10 year survival compared with nonresponders (60% vs 38%, p = 0.025). Responder status was associated with a survival advantage that persisted in risk-adjusted analysis (adjusted hazard ratio for long-term mortality, 0.66 [95% CI, 0.45-0.97]; p = 0.036). Conclusions Among patients with symptomatic PAD undergoing EVT, improvement of PAD-specific health status at 1 year follow-up was associated with improved long-term survival. Whether additional treatment for patients with poor response to EVT could improve long-term survival warrants further investigation.

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