Association of six-minute walk distance with subsequent lower extremity events in peripheral artery disease

Pooja Nayak, Jack M. Guralnik, Tamar S. Polonsky, Melina R. Kibbe, Lu Tian, Lihui Zhao, Michael H. Criqui, Luigi Ferrucci, Lingyu Li, Dongxue Zhang, Mary M. McDermott*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The prognostic significance of the six-minute walk distance for lower extremity events in people with peripheral artery disease (PAD) is unknown. This longitudinal study assessed whether a poorer six-minute walk distance at baseline was associated with higher rates of subsequent lower extremity atherosclerotic disease events in PAD. A total of 369 patients (mean age 69.4 ± 10.0 years; mean ankle–brachial index (ABI) 0.67 ± 0.17; 31% women; 30% black individuals) from Chicago-area medical centers with PAD were enrolled. Participants underwent baseline six-minute walk testing and returned for annual study visits. Lower extremity events consisted of one or more of the following: ABI decline greater than 15% or medical record adjudicated lower extremity revascularization, critical limb ischemia, or amputation. At a mean follow-up of 33.3 months, lower extremity events occurred in 66/123 (53.7%) people in the first (worst) tertile of six-minute walk performance, 55/124 (44.4%) in the second tertile, and 56/122 (45.9%) in the third (best) tertile. After adjusting for age, sex, race, ABI, comorbidities, and other confounders, participants in the first (worst) tertile of six-minute walk distance at baseline had higher rates of lower extremity events during follow-up, compared to those in the best tertile at baseline (HR = 1.74, 95% CI 1.17–2.60, p = 0.0067). Among people with PAD, a poorer six-minute walk distance was associated with higher rates of subsequent lower extremity PAD-related events after adjusting for confounders. Further study is needed to determine whether interventions that improve six-minute walk distance can reduce lower extremity adverse events in people with PAD.

Original languageEnglish (US)
Pages (from-to)319-327
Number of pages9
JournalVascular Medicine (United Kingdom)
Volume25
Issue number4
DOIs
StatePublished - Aug 1 2020

Keywords

  • amputation
  • critical limb ischemia (CLI)
  • peripheral artery disease (PAD)
  • six-minute walk

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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