TY - JOUR
T1 - Association of diabetes mellitus with health status outcomes in patients with peripheral artery disease
T2 - Insights from the portrait registry
AU - Patel, Krishna K.
AU - Alturkmani, Hani
AU - Gosch, Kensey
AU - Mena-Hurtado, Carlos
AU - Shishehbor, Mehdi H.
AU - Peri-Okonny, Poghni A.
AU - Creager, Mark A.
AU - Spertus, John A.
AU - Smolderen, Kim G.
N1 - Funding Information:
Research reported in this article was partially funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (IP2 PI000753-01; CE-1304-6677), the Netherlands Organization for Scientific Research (VENI grant number 916.11.179), and an unrestricted grant from W. L. Gore & Associates, Inc (Flagstaff, AZ). The statements in this article are solely the responsibility of the authors and do not necessarily represent the views of the PCORI, its Board of Governors, or Methodology Committee. All articles for the PORTRAIT trial are prepared by independent authors who are not governed by the funding sponsors and are reviewed by an academic publications committee before submission. Drs Patel and Peri-Okonny are supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) under award number T32HL110837. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funding organizations and sponsors of the study had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; or decision to submit the article for publication.
Funding Information:
Dr Spertus owns copyright for the Peripheral Artery Questionnaire. He serves as a consultant to United Healthcare, Bayer, Janssen, AstraZeneca, and Novartis. He is the principal investigator of an analytic center for the American College of Cardiology. He has an equity interest in Health Outcomes Sciences. Dr Mena-Hurtado serves as a consultant for Abbott, Cardinal Health, Boston Sci, Cook, Medtronic, and Bard BD. Dr Shishehbor is a consultant and serves on the global advisory board of Medtronic, Abbott Vascular, Terumo, Boston Scientific, and Philips. Dr Creager is supported by the American Heart Association Strategically Focused Research Network in Vascular Disease under award number 18SFRN339008. Dr Smolderen receives grant support from Boston Scientific, Abbott Vascular, and Terumo.
Funding Information:
Research reported in this article was partially funded through a PatientCentered Outcomes Research Institute (PCORI) Award (IP2 PI000753-01; CE-1304-6677), the Netherlands Organization for Scientific Research (VENI grant number 916.11.179), and an unrestricted grant from W. L. Gore & Associates, Inc (Flagstaff, AZ). The statements in this article are solely the responsibility of the authors and do not necessarily represent the views of the PCORI, its Board of Governors, or Methodology Committee. All articles for the PORTRAIT trial are prepared by independent authors who are not governed by the funding sponsors and are reviewed by an academic publications committee before submission. Drs Patel and Peri-Okonny are supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) under award number T32HL110837. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funding organizations and sponsors of the study had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; or decision to submit the article for publication.
Publisher Copyright:
© 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2020
Y1 - 2020
N2 - BACKGROUND: Patients with peripheral artery disease (PAD) and coexisting diabetes mellitus (DM) have greater PAD progression and adverse limb events. Our aim was to study whether PAD-specific health status differs by DM. METHODS AND RESULTS: The PORTRAIT (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) trial is a 16-center international registry that includes patients with recent exacerbations or new-onset symptomatic PAD presenting to specialty clinics. We assessed PAD-specific health status initially and at 3, 6, and 12 months (Peripheral Artery Questionnaire [PAQ]). We used hierarchical, multivariable, linear regression, and repeated measures analyses to study the association between DM and baseline health status initially and over 3 to 12 months. Models were adjusted for demographics, socioeconomic factors, PAD severity, comorbidities, and psychosocial characteristics. The interaction of DM with PAD revascularization on 3-to 12-month health status was also tested. Of 1204 patients, 398 (33%) had DM (94% type 2). Patients with versus those without DM had lower unadjusted PAQ summary scores at baseline and 3, 6, and 12 months (46.1 versus 50.8, 63.6 versus 68.2, 65.7 versus 71.7, and 65.4 versus 72.6; P≤0.01). In fully adjusted models, the effect of DM on baseline (mean difference, −0.65; 95% CI, −2.86 to 1.56 [P=0.56]) and over 3-to 12-month PAQ summary scores (mean difference, −1.59; 95% CI, −4.06 to 0.88 [P=0.21]) was no longer significant. Twelve-month health status gains following revascularization were similar in both groups (P=0.69). CONCLUSIONS: Patients with PAD with coexisting DM have poorer health status, mostly explained by the differences in their psychosocial and other comorbidity burden. Patients with PAD and DM versus those without DM experience similar health status benefits following PAD revascularization.
AB - BACKGROUND: Patients with peripheral artery disease (PAD) and coexisting diabetes mellitus (DM) have greater PAD progression and adverse limb events. Our aim was to study whether PAD-specific health status differs by DM. METHODS AND RESULTS: The PORTRAIT (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) trial is a 16-center international registry that includes patients with recent exacerbations or new-onset symptomatic PAD presenting to specialty clinics. We assessed PAD-specific health status initially and at 3, 6, and 12 months (Peripheral Artery Questionnaire [PAQ]). We used hierarchical, multivariable, linear regression, and repeated measures analyses to study the association between DM and baseline health status initially and over 3 to 12 months. Models were adjusted for demographics, socioeconomic factors, PAD severity, comorbidities, and psychosocial characteristics. The interaction of DM with PAD revascularization on 3-to 12-month health status was also tested. Of 1204 patients, 398 (33%) had DM (94% type 2). Patients with versus those without DM had lower unadjusted PAQ summary scores at baseline and 3, 6, and 12 months (46.1 versus 50.8, 63.6 versus 68.2, 65.7 versus 71.7, and 65.4 versus 72.6; P≤0.01). In fully adjusted models, the effect of DM on baseline (mean difference, −0.65; 95% CI, −2.86 to 1.56 [P=0.56]) and over 3-to 12-month PAQ summary scores (mean difference, −1.59; 95% CI, −4.06 to 0.88 [P=0.21]) was no longer significant. Twelve-month health status gains following revascularization were similar in both groups (P=0.69). CONCLUSIONS: Patients with PAD with coexisting DM have poorer health status, mostly explained by the differences in their psychosocial and other comorbidity burden. Patients with PAD and DM versus those without DM experience similar health status benefits following PAD revascularization.
KW - Diabetes mellitus
KW - Health-related quality of life
KW - Peripheral artery disease
UR - http://www.scopus.com/inward/record.url?scp=85096347725&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.017103
DO - 10.1161/JAHA.120.017103
M3 - Review article
C2 - 33153398
AN - SCOPUS:85096347725
SN - 2047-9980
VL - 9
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 22
M1 - e017103
ER -