Abstract 250: Gender Differences in Health Status Amongst Patients with Peripheral Artery Disease

Abstract

Aim: Unlike other cardiovascular disorders, few studies have examined gender differences in health outcomes in peripheral artery disease (PAD) patients. This study assessed whether gender was an independent determinant of health status at (a) initial diagnosis of PAD, (b) 12-month follow-up, or (c) the rate of change over a 12-month period, with the hypothesis that women's PAD health status will be comprised at both time points. Methods: From March'06 to November '10, 588 patients (381 men, 207 women) with newly diagnosed PAD (Rutherford stages I-III) were consecutively enrolled from two vascular clinics in the Netherlands. Clinical details were recorded and patients completed the Short Form 12 (SF-12) questionnaire at baseline and 12 months later. Physical (PCS) and mental component summary (MCS) scores were calculated and compared by gender at each time point and median values were used due to non-normally distributed data. Multivariable linear regression models adjusting for demographics, cardiovascular risk factors, co-morbidities and depression quantified the independent association of gender with health status. Results: Women had poorer PCS (36±10 vs. 40±10, P<0.001) and MCS (46±12 vs. 49±11, P<0.001) scores at diagnosis (baseline) as compared with men ( Figure 1 ). Independent correlates of poorer baseline PCS included age, body mass index, prior cardiovascular history, chronic obstructive pulmonary disease (COPD), and depression. For baseline MCS scores, indicators of poorer outcomes included female gender, age, COPD, and depression. Although PCS scores improved for both genders over 12 months (P<0.001 for men; P<.0.001 for women), 12-month MCS scores did not significantly change in men (P=0.14) or women (P=0.12) ( Figure 1 ). At 12 months, both PCS and MCS were worse in women, as compared with men (PCS [41+12 vs. 46+11, P=0.05], MCS [43+14 vs. 49+12, P=0.002]). Independent predictors in the rate of improvement in PCS scores included age, diabetes, and PCS-12 at baseline, but not gender, with no independent predictors for the MCS scores. Conclusion: Women with lower-extremity PAD have poorer physical and mental health status scores both at baseline and 12 months, however, improvement 12 months following diagnosis was independent of gender. Figure 1. Median PCS and MCS Scores at Baseline and 12-Month Follow-Up by Gender