AIM: To assess the predictive value of a decline in total walking distance and ankle brachial index (ABI) on all-cause mortality and cardiac death in patients with known or suspected peripheral artery disease. METHODS: Two hundred and sixty-one patients, who performed single-stage treadmill walking test twice to evaluate their peripheral artery disease, were enrolled in an observational study. Patients who underwent surgery during follow-up were excluded. Delta total walking distance and delta resting and exercise ABI consisted of the difference between the first and the second test. All three variables were categorized into two groups: stable/improvement or a decline. RESULTS: The mean follow-up period was 6 years. At both 5 years and total follow-up, a decline in total walking distance was independent and highly associated with an increased mortality risk and cardiac death [hazard ratio: 2.31 (95% confidence interval 1.35-3.96); hazard ratio: 3.55 (95% confidence interval: 1.53-8.21), respectively]. A decline in resting or exercise ABI after adjustment for delta walking distance was not significantly associated with all-cause mortality or cardiac death. CONCLUSION: A decline in total walking distance in single-stage treadmill exercise tests is a strong prognostic predictor of all-cause mortality and cardiac death in the short term and long term.

Additional Metadata
Keywords Ankle brachial index, Cardiac death, Exercise test, Mortality, Peripheral artery disease, Walking distance
Persistent URL dx.doi.org/10.1097/HJR.0b013e32833254ce, hdl.handle.net/1765/20163
Citation
de Liefde, I.I, van Domburg, R.T, Bax, J.J, Klein, J, Verhagen, H.J.M, & Poldermans, D. (2010). A decline in walking distance predicts long-term outcome in patients with known or suspected peripheral artery disease. European Journal of Cardiovascular Prevention & Rehabilitation, 17(3), 321–328. doi:10.1097/HJR.0b013e32833254ce