Low Walking Impairment Questionnaire score after a recent myocardial infarction identifies patients with polyvascular disease

OBJECTIVES: To evaluate whether the Walking Impairment Questionnaire score could identify patients with polyvascular disease in a population with recent myocardial infarction and their association with cardiovascular events during two-year follow-up. DESIGN: A prospective observational study. SETTING: Patients admitted to the acute coronary care unit, the Department of Cardiology, Uppsala University Hospital. PARTICIPANTS: Patients admitted with acute Non-STEMI- or STEMI-elevation myocardial infarction. MAIN OUTCOME MEASURES: The Walking Impairment Questionnaire, developed as a self-administered instrument to assess walking distance, speed, and stair climbing in patients with peripheral artery disease, predicts future cardiovascular events and mortality. Two hundred and sixty-three patients with recent myocardial infarction answered Walking Impairment Questionnaire. Polyvascular disease was defined as abnormal findings in the coronary- and carotid arteries and an abnormal ankle–brachial index. The calculated score for each of all three categories were divided into quartiles with the lowest score in first quartile. RESULTS: The lowest (worst) quartile in all three Walking Impairment Questionnaire categories was associated with polyvascular disease, fully adjusted; distance, odds ratio (OR) 5.4 (95% confidence interval (CI) 1.8–16.1); speed, OR 7.4 (95% CI 1.5–36.5); stair climbing, OR 8.4 (95% CI 1.0–73.6). In stair climbing score, patients with the lowest (worst) score had a higher risk for the composite cardiovascular endpoint compared to the highest (best) score; hazard ratio 5.3 (95% CI 1.5–19.0). The adherence to medical treatment was high (between 81.7% and 99.2%). CONCLUSIONS: The Walking Impairment Questionnaire is a simple tool to identify myocardial infarction patients with more widespread atherosclerotic disease and although well treated medically, stair climbing predicts cardiovascular events.