Reduced Gait Speed Is Associated With Poor Prognosis in Patients With Peripheral Artery Disease After...

Peripheral artery disease (PAD) causes claudication and distal lower extremity muscle impairment. While endovascular treatment (EVT) improves symptoms, cardiovascular events remain high. Previous studies have linked muscle mass to adverse outcomes, focusing on proximal muscles rather than distal muscle dysfunction. This study investigated whether gait speed demonstrates greater prognostic value than systemic muscle indicators.

This study included 248 patients with PAD who received EVT. Gait speed, isometric knee extensor strength (IKES), and grip strength (GS) were assessed and classified into reduced or preserved groups based on cutoff values (gait speed: <1.0 m/s; IKES: <0.4 kgf/kg; GS: <28 kg for males, <18 kg for females). The primary outcome was a composite of all-cause mortality and major adverse cardiovascular and limb events and was compared between groups using Kaplan-Meier curves and Cox proportional hazards regression analysis.

During a median follow-up of 972 days, the primary outcome occurred in 46 (19%) patients. Kaplan-Meier curves demonstrated that reduced gait speed and decreased IKES showed higher rates of primary outcome (P < .001 and P = .016, respectively), while reduced GS showed no association (P = .184). After multivariate adjustment, reduced gait speed remained an independent predictor (HR = 2.38, P = .007), while IKES and GS were no longer significant.

In this preliminary study, reduced gait speed, but not IKES and GS, was associated with the composite outcome. This result indicates that gait speed may be a risk stratification tool for patients with PAD following EVT.