Abstract 1898: A Prognostic Risk Index Predicts Long-Term Mortality in Patients with Peripheral Arterial Disease
Background: Prognostic information in patients with peripheral arterial disease (PAD) may provide the basis for optimal treatment strategies. In this study, a prognostic risk index for 10-year mortality was developed in a derivation cohort and validated in a comparable cohort.
Methods and results: A total of 2642 patients with PAD were randomly divided into derivation (n=1332) and validation (n=1310) cohorts. During 10 years follow-up, all-cause mortality was recorded in 42.2% patients in the derivation and 40.4% in the validation cohort. Multivariate regression analysis identified independent predictors of 10-year mortality and weighted points were assigned to each variable based on the beta-coefficient: renal failure (+12), heart failure (+7), ST-segment changes (+5), age >65 years (+5), hyperlipidemia (+5), ankle-brachial index <0.60 (+4), Q-waves (+3), diabetes (+3), stroke (+3). Statins (−6), aspirin (−4), and β-blockers (−4) were independently associated with reduced 10-year mortality risk. These variables constituted the prognostic risk index with a discrimination of 0.70. Patients were stratified into four different risk categories: low (<0), low intermediate (0–5), high intermediate (6 –9), high (>9). In the different risk categories, estimated 10-year mortality rate are presented in the Figure⇓ (p<0.001). Using the prognostic risk index from the derivation cohort, similar mortality rates were observed in the validation cohort.
Conclusion: A prognostic risk index for 10-year mortality stratifies patients with peripheral arterial disease into different risk categories, which may be useful for patient counselling and medical decision making.