Gender Differences in Health Status and Adverse Outcomes Among Patients With Peripheral Arterial Disease

Author:

Dreyer Rachel P.12,van Zitteren Moniek34,Beltrame John F.5,Fitridge Robert6,Denollet Johan3,Vriens Patrick W.4,Spertus John A.78,Smolderen Kim G.78

Affiliation:

1. Center for Outcomes Research and Evaluation (CORE), New Haven, CT

2. Department of Internal Medicine Yale School of Medicine, New Haven, CT

3. CoRPS–Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands

4. Department of Vascular Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands

5. Discipline of Medicine, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia

6. Discipline of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia

7. Saint Luke's Mid America Heart Institute, Kansas City, MO

8. UMKC–University of Missouri‐Kansas City, Kansas City, MO

Abstract

Background Few studies have examined gender differences in health status and cardiovascular outcomes in patients with peripheral artery disease ( PAD ). This study assessed (1) self‐reported health status at PAD diagnosis and 12‐months later, and explored (2) whether outcomes in women with PAD differ with regard to long‐term major adverse events. Methods and Results A total of 816 patients (285 women) with PAD were enrolled from 2 vascular clinics in the Netherlands. Baseline clinical data and subsequent adverse events were recorded and patients completed the Short Form‐12 ( SF ‐12, Physical Component Score [ PCS ] and Mental Component Score [ MCS ]) upon PAD diagnosis and 12‐months later. Women had similar ages and clinical characteristics, but poorer socio‐economic status and more depressive symptoms at initial diagnosis, as compared with men. Women also had poorer physical ( PCS : 37±10 versus 40±10, P =0.004) and mental ( MCS : 47±12 versus 49±11, P =0.005) health status at the time of presentation. At 12‐months, women still reported a poorer overall PCS score (41±12 versus 46±11, P =0.006) and MCS score (42±14 versus 49±12, P =0.002). Female gender was an independent determinant of a poorer baseline and 12‐month PCS and MCS scores. However, there were no significant differences by gender on either mortality (unadjusted hazard ratio [ HR ]=0.93, 95% CI 0.60;1.44, P =0.74) or major adverse events (unadjusted HR =0.90, 95% CI 0.63;1.29, P =0.57), after a median follow‐up of 3.2 years. Conclusions Women's physical and mental health status is compromised both at initial PAD diagnosis and at 12‐month follow‐up, despite experiencing a similar magnitude of change in their health scores throughout the first 12‐months after diagnosis.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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