Abstract 325: Usefulness of Peripheral Vascular Disease Assessment on Readmission in a Heart Failure Program Cohort

Abstract

Background: Peripheral arterial disease (PAD) was reported to have a relationship with functional capacity in heart failure patients. Heart failure patients presenting with a good functional capacity have been found to have better metabolic equivalents (METs). Recognizing and managing patients’ functional capacity surrogates like ankle-brachial index (ABI) and METs will be beneficial to improve the rate of readmission, however, little is known about the relationship with readmission rate in heart failure patients. We assessed readmission rate within 30 days after discharge using functional capacity assessment. Methods: 860 patients who were followed in the cardiology clinic from 2005 to 2015 were included. We analyzed the 240 patients who were admitted with a diagnosis of acute heart failure. Patients who were unable to cardiac rehabilitation or who had severe lung disease were excluded. Heart failure is classified as a reduced ejection fraction (HFrEF, EF <40) and preserved ejection fraction (HFpEF, EF>=50). MET (Metabolic equivalents) level was used for functional capacity. If ABI was less than 0.9 or over 1.4, patients were regarded to have peripheral arterial disease.We found no significant difference between our HFpEF and HFrEF patients (Mean METS 7.5±0.6 vs 7.4±0.7). ABI did not show any significant difference (1.1±0.2 vs 1.0±0.3). In multiple logistic regression analyses, HFpEF patients with more than 4 MET level were likely to have fewer readmissions rate compared to HFpEF patients with less than 4 METS level [odds ratio (OR): 0.54, confidence interval (CI): 0.35-0.81]. HFpEF patients with ABI between 0.9 and 1.4 had less readmission rate compared to HFpEF with less than 0.9 or more than 1.4 ABI [OR: 0.62, CI: 0.41-0.77] after related risk factors adjustment. Conclusion: In conclusion, good functional status with better METs and ABI in HFpEF patients was significantly associated with less readmission rate. ABI might be a surrogate factor for assessing functional capacity in HFpEF patients. This result implies that heart failure patients’ functional capacity might need to be assessed to decrease readmission rate.