Outcome events in patients with claudication: a 15-year study in 2777 patients

Area of Science:

• Vascular Medicine
• Epidemiology
• Cardiology

Background:

• Claudication, a symptom of peripheral artery disease, significantly impacts patient prognosis.
• Understanding the natural history and mortality risk factors is crucial for effective patient management.

Purpose of the Study:

• To delineate the natural history of claudication.
• To identify independent risk factors associated with mortality in claudicant patients.

Main Methods:

• A retrospective review of 2777 male patients with claudication over 15 years.
• Exclusion of patients with rest pain or ulcers.
• Analysis using life-table and Cox hazard models.

Main Results:

• Annual mortality rate was 12%, higher than the age-adjusted US male population.
• Significant predictors of death: older age, low ankle-brachial index, diabetes requiring medication, and stroke.
• Low 10-year cumulative rates for amputation (<10%) and revascularization (18%).

Conclusions:

• Claudication patients face a high mortality rate, with specific risk factors identified.
• A predictive model for mortality risk stratification can aid therapeutic planning.
• Absence of angina/myocardial infarction as predictors suggests claudication may precede coronary symptoms.