Saint Luke's Mid America Heart Institute, Kansas City, Missouri; University of Missouri-Kansas City, Kansas City, Missouri.
Kansas City University of Medicine and Biosciences, Kansas City, Missouri.
Am J Cardiol. 2021 Jan 1;138:107-113. doi: 10.1016/j.amjcard.2020.10.011. Epub 2020 Oct 13.
The association of invasive versus noninvasive treatment and physical activity level in patients with claudication remains unclear. Participants with claudication were enrolled from US vascular clinics. Treatment was categorized as invasive (surgical or endovascular treatment <3 months of initial visit) versus noninvasive. Self-reported leisure time (LTPA) and work related physical activity (WRPA) (sedentary, mild, moderate/strenuous), and health status (peripheral artery questionnaire summary score [PAQ SS]) was measured at baseline and 12 months. Change in PA was also categorized as increased, decreased, persistent sedentary [reference] and persistent active based on activity status at baseline and 12 months. Multivariable logistic regression assessed the association of treatment with 12-month LTPA and WRPA. Multivariable linear regression examined the association between 12-month change in PA with a 12-month change in PAQ. A total of 196of 656 patients (29.9%) underwent invasive treatment. There was no association between treatment and 12-month LTPA (p = 0.77) or WRPA (p = 0.26). Compared with being persistently sedentary, increased LTPA was associated with increased PAQ SS (OR 11.1 95% CI [4.4 to 17.7], p <0.01). In conclusion, there was no association between invasive treatment and physical activity at follow up despite a greater health status change in the invasive group. As increased physical activity was associated with more health status gains than remaining sedentary, additional ways to improve physical activity levels could potentially improve PAD outcomes.
在跛行患者中,侵入性与非侵入性治疗与体力活动水平之间的关联仍不清楚。跛行患者从美国血管诊所招募。治疗分为侵入性(手术或血管内治疗<初始就诊后 3 个月)与非侵入性。在基线和 12 个月时测量自我报告的休闲时间(LTPA)和与工作相关的体力活动(WRPA)(久坐、轻度、中度/剧烈)以及健康状况(外周动脉问卷综合评分[PAQ SS])。PA 的变化也根据基线和 12 个月的活动状态分为增加、减少、持续久坐[参考]和持续活跃。多变量逻辑回归评估了治疗与 12 个月 LTPA 和 WRPA 的关联。多变量线性回归检查了 12 个月 PA 变化与 12 个月 PAQ 变化之间的关联。在 656 名患者中,有 196 名(29.9%)接受了侵入性治疗。治疗与 12 个月 LTPA(p=0.77)或 WRPA(p=0.26)之间没有关联。与持续久坐相比,LTPA 增加与 PAQ SS 增加相关(OR 11.1,95%CI[4.4 至 17.7],p<0.01)。总之,尽管侵入性治疗组的健康状况变化更大,但在随访中,侵入性治疗与体力活动之间没有关联。由于增加体力活动比保持久坐更能带来更多的健康状况改善,因此可能需要寻找其他方法来提高体力活动水平,从而改善 PAD 结局。