One-Year Health Status Outcomes Following Early Invasive and Noninvasive Treatment in Symptomatic Peripheral Artery...

Area of Science:

• Vascular Surgery
• Patient-Centered Outcomes
• Peripheral Artery Disease

Background:

• Lifestyle changes and medications are first-line treatments for claudication.
• Revascularization is reserved for treatment-resistant symptoms, guided by patient preference.
• Limited real-world data exists comparing early invasive versus noninvasive management strategies for claudication health status outcomes.

Purpose of the Study:

• To compare one-year health status trajectories in patients with claudication undergoing early revascularization versus noninvasive management.
• To provide real-world evidence on the effectiveness of different management strategies for claudication.

Main Methods:

• Prospective observational study using the PORTRAIT registry.
• Assessed disease-specific health status using the Peripheral Artery Questionnaire (PAQ) at baseline and 3, 6, and 12 months.
• Compared one-year health status trajectories between early revascularization and noninvasive management groups using propensity-matched samples and hierarchical generalized linear models.

Main Results:

• A propensity-matched sample of 1000 patients (29.7% early revascularization, 70.3% noninvasive management) was analyzed.
• Patients undergoing early invasive management reported significantly higher health status across all PAQ domains over 1 year (P<0.001).
• The average 1-year improvement in PAQ summary scores was 30.8 in the early invasive group versus 16.7 in the noninvasive group (P<0.001).

Conclusions:

• Early invasive treatment for claudication leads to greater health status improvements over one year compared to noninvasive management.
• These findings can inform shared decision-making processes between clinicians and patients regarding treatment options for claudication.