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Effect of peripheral arterial disease on functional and clinical outcomes in patients with heart failure (from HF-ACTION).

Publication ,  Journal Article
Jones, WS; Clare, R; Ellis, SJ; Mills, JS; Fischman, DL; Kraus, WE; Whellan, DJ; O'Connor, CM; Patel, MR
Published in: Am J Cardiol
August 1, 2011

Patients with peripheral arterial disease (PAD) have lower functional capacity and worse clinical outcomes than age- and gender-matched patients. Few data exist on the relation of PAD to functional and clinical outcomes in patients with heart failure (HF). We sought to compare patients with HF with and without PAD for baseline functional capacity, response to exercise training, and clinical outcomes. HF-ACTION was a randomized controlled trial comparing usual care to structured exercise training plus usual care in patients with HF and an ejection fraction ≤35% and New York Heart Association class II to IV HF symptoms. Cardiopulmonary exercise testing occurred at enrollment, 3 months, and 1 year. Clinical follow-up occurred up to 4 years. Of the 2,331 HF-ACTION patients, 157 (6.8%) had PAD. At baseline, patients with HF and PAD had a shorter exercise duration (8.0 vs 9.8 minutes, p <0.001), lower peak oxygen consumption (12.5 vs 14.6 ml/kg/min, p <0.001), and shorter 6-minute walking distance (306 vs 371 m, p <0.001) compared to patients with HF without PAD. At 3 months patients with HF and PAD had less improvement on cardiopulmonary exercise testing (exercise duration 0.5 vs 1.1 minutes, p = 0.002; mean change in peak oxygen consumption 0.1 vs 0.6 ml/kg/min, p = 0.04) compared to patients with HF without PAD. PAD was an independent predictor of all-cause death or hospitalization (hazard ratio 1.31, 95% confidence interval 1.06 to 1.62, p = 0.011). Patients with PAD and HF had deceased baseline exercise capacity and decreased response to exercise training. In conclusion, PAD is an independent predictor of all-cause death or hospitalization in patients with HF.

Duke Scholars

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

August 1, 2011

Volume

108

Issue

3

Start / End Page

380 / 384

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Proportional Hazards Models
  • Peripheral Arterial Disease
  • Oxygen
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Humans
  • Heart Failure
 

Citation

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ICMJE
MLA
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Jones, W. S., Clare, R., Ellis, S. J., Mills, J. S., Fischman, D. L., Kraus, W. E., … Patel, M. R. (2011). Effect of peripheral arterial disease on functional and clinical outcomes in patients with heart failure (from HF-ACTION). Am J Cardiol, 108(3), 380–384. https://doi.org/10.1016/j.amjcard.2011.03.057
Jones, W Schuyler, Robert Clare, Stephen J. Ellis, James S. Mills, David L. Fischman, William E. Kraus, David J. Whellan, Christopher M. O’Connor, and Manesh R. Patel. “Effect of peripheral arterial disease on functional and clinical outcomes in patients with heart failure (from HF-ACTION).Am J Cardiol 108, no. 3 (August 1, 2011): 380–84. https://doi.org/10.1016/j.amjcard.2011.03.057.
Jones WS, Clare R, Ellis SJ, Mills JS, Fischman DL, Kraus WE, et al. Effect of peripheral arterial disease on functional and clinical outcomes in patients with heart failure (from HF-ACTION). Am J Cardiol. 2011 Aug 1;108(3):380–4.
Jones, W. Schuyler, et al. “Effect of peripheral arterial disease on functional and clinical outcomes in patients with heart failure (from HF-ACTION).Am J Cardiol, vol. 108, no. 3, Aug. 2011, pp. 380–84. Pubmed, doi:10.1016/j.amjcard.2011.03.057.
Jones WS, Clare R, Ellis SJ, Mills JS, Fischman DL, Kraus WE, Whellan DJ, O’Connor CM, Patel MR. Effect of peripheral arterial disease on functional and clinical outcomes in patients with heart failure (from HF-ACTION). Am J Cardiol. 2011 Aug 1;108(3):380–384.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

August 1, 2011

Volume

108

Issue

3

Start / End Page

380 / 384

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Proportional Hazards Models
  • Peripheral Arterial Disease
  • Oxygen
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Humans
  • Heart Failure