Association Between Health Status and Long-Term Mortality After Percutaneous Revascularization of Peripheral Artery Disease

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 1year 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) 1year after their index procedure (79%) were identified as responders. Responders had a significantly better 10year 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 1year 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. (C) 2016 Wiley Periodicals, Inc.