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Association of Diabetes Mellitus With Health Status Outcomes in Patients With Peripheral Artery Disease: Insights From the PORTRAIT Registry. | LitMetric

AI Article Synopsis

  • Patients with peripheral artery disease (PAD) and diabetes mellitus (DM) show poorer health status compared to those without DM, as indicated by lower scores on the Peripheral Artery Questionnaire (PAQ) at multiple time points.
  • The study analyzed data from the PORTRAIT trial, which involved 1,204 patients, finding that the negative impact of DM on health status diminished when accounting for other factors like comorbidities and psychosocial issues.
  • Despite initial differences in health status, patients with PAD and DM experienced similar improvements after undergoing revascularization procedures when compared to those without DM.

Article Abstract

Background Patients with peripheral artery disease (PAD) and coexisting diabetes mellitus (DM) have greater PAD progression and adverse limb events. Our aim was to study whether PAD-specific health status differs by DM. Methods and Results The PORTRAIT (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) trial is a 16-center international registry that includes patients with recent exacerbations or new-onset symptomatic PAD presenting to specialty clinics. We assessed PAD-specific health status initially and at 3, 6, and 12 months (Peripheral Artery Questionnaire [PAQ]). We used hierarchical, multivariable, linear regression, and repeated measures analyses to study the association between DM and baseline health status initially and over 3 to 12 months. Models were adjusted for demographics, socioeconomic factors, PAD severity, comorbidities, and psychosocial characteristics. The interaction of DM with PAD revascularization on 3- to 12-month health status was also tested. Of 1204 patients, 398 (33%) had DM (94% type 2). Patients with versus those without DM had lower unadjusted PAQ summary scores at baseline and 3, 6, and 12 months (46.1 versus 50.8, 63.6 versus 68.2, 65.7 versus 71.7, and 65.4 versus 72.6; ≤0.01). In fully adjusted models, the effect of DM on baseline (mean difference, -0.65; 95% CI, -2.86 to 1.56 [=0.56]) and over 3- to 12-month PAQ summary scores (mean difference, -1.59; 95% CI, -4.06 to 0.88 [=0.21]) was no longer significant. Twelve-month health status gains following revascularization were similar in both groups (=0.69). Conclusions Patients with PAD with coexisting DM have poorer health status, mostly explained by the differences in their psychosocial and other comorbidity burden. Patients with PAD and DM versus those without DM experience similar health status benefits following PAD revascularization.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763706PMC
http://dx.doi.org/10.1161/JAHA.120.017103DOI Listing

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