Correlation of patient-reported symptom outcomes and treadmill test outcomes after treatment for aortoiliac claudication

J Vasc Interv Radiol. 2013 Oct;24(10):1427-35; quiz 1436. doi: 10.1016/j.jvir.2013.05.057. Epub 2013 Jul 29.

Abstract

Purpose: To examine the relationship between objective treadmill test outcomes and subjective symptom outcomes among patients with claudication treated with stent revascularization (ST) compared with supervised exercise (SE).

Materials and methods: Five scales of the Peripheral Artery Questionnaire and Walking Impairment Questionnaire were correlated with peak walking time and treadmill claudication onset time.

Results: The correlation between change in disease-specific quality of life (QOL) and change in peak walking time differed according to treatment group, with statistically significant correlations for all five scales for the ST group and weaker trends for the SE group, only one of which was statistically significant. In contrast, improvements in disease-specific QOL correlated well with increases in claudication onset time, with no significant interaction with treatment group for any of the five scales.

Conclusions: Disease-specific QOL results at 6 months in the Claudication: Exercise Vs. Endoluminal Revascularization (CLEVER) study show that improved maximal treadmill walking in patients with claudication treated with SE correlated poorly with self-reported symptom relief. Conversely, patients treated with ST showed good correlation between improved maximal treadmill walking and self-reported symptom improvement. The correlation between claudication onset time and self-reported symptom relief was good across treatment groups. This finding indicates that traditional objective treadmill test outcomes may not correlate well with symptom relief in patients with claudication. Future studies should investigate these data and improve understanding of patient relevance of traditional objective treadmill-based treatment outcomes.

Keywords: CLEVER; COT; Claudication: Exercise Vs. Endoluminal Revascularization; OMC; PAD; PAQ; PWT; Peripheral Artery Questionnaire; QOL; SE; ST; WIQ; Walking Impairment Questionnaire; claudication onset time; optimal medical care; peak walking time; peripheral artery disease; quality of life; stent revascularization; supervised exercise.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Vessel Prosthesis / statistics & numerical data
  • Diagnostic Self Evaluation*
  • Exercise Test / statistics & numerical data*
  • Female
  • Humans
  • Intermittent Claudication / diagnosis*
  • Intermittent Claudication / epidemiology
  • Intermittent Claudication / surgery*
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / diagnosis*
  • Peripheral Arterial Disease / epidemiology
  • Peripheral Arterial Disease / surgery*
  • Prevalence
  • Quality of Life*
  • Recovery of Function
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Single-Blind Method
  • Statistics as Topic
  • Stents / statistics & numerical data
  • Surveys and Questionnaires
  • Treatment Outcome
  • United States / epidemiology