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Association of Lower Extremity Performance With Cardiovascular and All‐Cause Mortality in Patients With Peripheral Artery Disease: A Systematic Review and Meta‐Analysis

BACKGROUND: Peripheral artery disease (PAD) is associated with impaired mobility and a high rate of mortality. The aim of this systematic review was to investigate whether reduced lower extremity performance was associated with an increased incidence of cardiovascular and all‐cause mortality in peop...

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Autores principales: Morris, Dylan R., Rodriguez, Alexander J., Moxon, Joseph V., Cunningham, Margaret A., McDermott, Mary M., Myers, Jonathan, Leeper, Nicholas J., Jones, Rhondda E., Golledge, Jonathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310407/
https://www.ncbi.nlm.nih.gov/pubmed/25122666
http://dx.doi.org/10.1161/JAHA.114.001105
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author Morris, Dylan R.
Rodriguez, Alexander J.
Moxon, Joseph V.
Cunningham, Margaret A.
McDermott, Mary M.
Myers, Jonathan
Leeper, Nicholas J.
Jones, Rhondda E.
Golledge, Jonathan
author_facet Morris, Dylan R.
Rodriguez, Alexander J.
Moxon, Joseph V.
Cunningham, Margaret A.
McDermott, Mary M.
Myers, Jonathan
Leeper, Nicholas J.
Jones, Rhondda E.
Golledge, Jonathan
author_sort Morris, Dylan R.
collection PubMed
description BACKGROUND: Peripheral artery disease (PAD) is associated with impaired mobility and a high rate of mortality. The aim of this systematic review was to investigate whether reduced lower extremity performance was associated with an increased incidence of cardiovascular and all‐cause mortality in people with PAD. METHODS AND RESULTS: A systematic search of the MEDLINE, EMBASE, SCOPUS, Web of Science, and Cochrane Library databases was conducted. Studies assessing the association between measures of lower extremity performance and cardiovascular or all‐cause mortality in PAD patients were included. A meta‐analysis was conducted combining data from commonly assessed performance tests. The 10 identified studies assessed lower extremity performance by strength tests, treadmill walking performance, 6‐minute walk, walking velocity, and walking impairment questionnaire (WIQ). A meta‐analysis revealed that shorter maximum walking distance was associated with increased 5‐year cardiovascular (unadjusted RR=2.54, 95% CI 1.86 to 3.47, P<10(−5), n=1577, fixed effects) and all‐cause mortality (unadjusted RR=2.23 95% CI 1.85 to 2.69, P<10(−5), n=1710, fixed effects). Slower 4‐metre walking velocity, a lower WIQ stair‐climbing score, and poor hip extension, knee flexion, and plantar flexion strength were also associated with increased mortality. No significant associations were found for hip flexion strength, WIQ distance score, or WIQ speed score with mortality. CONCLUSIONS: A number of lower extremity performance measures are prognostic markers for mortality in PAD and may be useful clinical tools for identifying patients at higher risk of death. Further studies are needed to determine whether interventions that improve measures of lower extremity performance reduce mortality.
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spelling pubmed-43104072015-02-10 Association of Lower Extremity Performance With Cardiovascular and All‐Cause Mortality in Patients With Peripheral Artery Disease: A Systematic Review and Meta‐Analysis Morris, Dylan R. Rodriguez, Alexander J. Moxon, Joseph V. Cunningham, Margaret A. McDermott, Mary M. Myers, Jonathan Leeper, Nicholas J. Jones, Rhondda E. Golledge, Jonathan J Am Heart Assoc Original Research BACKGROUND: Peripheral artery disease (PAD) is associated with impaired mobility and a high rate of mortality. The aim of this systematic review was to investigate whether reduced lower extremity performance was associated with an increased incidence of cardiovascular and all‐cause mortality in people with PAD. METHODS AND RESULTS: A systematic search of the MEDLINE, EMBASE, SCOPUS, Web of Science, and Cochrane Library databases was conducted. Studies assessing the association between measures of lower extremity performance and cardiovascular or all‐cause mortality in PAD patients were included. A meta‐analysis was conducted combining data from commonly assessed performance tests. The 10 identified studies assessed lower extremity performance by strength tests, treadmill walking performance, 6‐minute walk, walking velocity, and walking impairment questionnaire (WIQ). A meta‐analysis revealed that shorter maximum walking distance was associated with increased 5‐year cardiovascular (unadjusted RR=2.54, 95% CI 1.86 to 3.47, P<10(−5), n=1577, fixed effects) and all‐cause mortality (unadjusted RR=2.23 95% CI 1.85 to 2.69, P<10(−5), n=1710, fixed effects). Slower 4‐metre walking velocity, a lower WIQ stair‐climbing score, and poor hip extension, knee flexion, and plantar flexion strength were also associated with increased mortality. No significant associations were found for hip flexion strength, WIQ distance score, or WIQ speed score with mortality. CONCLUSIONS: A number of lower extremity performance measures are prognostic markers for mortality in PAD and may be useful clinical tools for identifying patients at higher risk of death. Further studies are needed to determine whether interventions that improve measures of lower extremity performance reduce mortality. Blackwell Publishing Ltd 2014-08-13 /pmc/articles/PMC4310407/ /pubmed/25122666 http://dx.doi.org/10.1161/JAHA.114.001105 Text en © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Morris, Dylan R.
Rodriguez, Alexander J.
Moxon, Joseph V.
Cunningham, Margaret A.
McDermott, Mary M.
Myers, Jonathan
Leeper, Nicholas J.
Jones, Rhondda E.
Golledge, Jonathan
Association of Lower Extremity Performance With Cardiovascular and All‐Cause Mortality in Patients With Peripheral Artery Disease: A Systematic Review and Meta‐Analysis
title Association of Lower Extremity Performance With Cardiovascular and All‐Cause Mortality in Patients With Peripheral Artery Disease: A Systematic Review and Meta‐Analysis
title_full Association of Lower Extremity Performance With Cardiovascular and All‐Cause Mortality in Patients With Peripheral Artery Disease: A Systematic Review and Meta‐Analysis
title_fullStr Association of Lower Extremity Performance With Cardiovascular and All‐Cause Mortality in Patients With Peripheral Artery Disease: A Systematic Review and Meta‐Analysis
title_full_unstemmed Association of Lower Extremity Performance With Cardiovascular and All‐Cause Mortality in Patients With Peripheral Artery Disease: A Systematic Review and Meta‐Analysis
title_short Association of Lower Extremity Performance With Cardiovascular and All‐Cause Mortality in Patients With Peripheral Artery Disease: A Systematic Review and Meta‐Analysis
title_sort association of lower extremity performance with cardiovascular and all‐cause mortality in patients with peripheral artery disease: a systematic review and meta‐analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310407/
https://www.ncbi.nlm.nih.gov/pubmed/25122666
http://dx.doi.org/10.1161/JAHA.114.001105
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