Gender Differences in Health Status and Adverse Outcomes Among Patients With Peripheral Arterial Disease

Background-—Few studies have examined gender differences in health status and cardiovascular outcomes in patients with peripheral artery disease (PAD). This study assessed (1) self-reported health status at PAD diagnosis and 12-months later, and explored (2) whether outcomes in women with PAD differ with regard to long-term major adverse events. Methods and Results-—A total of 816 patients (285 women) with PAD were enrolled from 2 vascular clinics in the Netherlands. Baseline clinical data and subsequent adverse events were recorded and patients completed the Short Form-12 (SF-12, Physical Component Score [PCS] and Mental Component Score [MCS]) upon PAD diagnosis and 12-months later. Women had similar ages and clinical characteristics, but poorer socio-economic status and more depressive symptoms at initial diagnosis, as compared with men. Women also had poorer physical (PCS: 3710 versus 4010, P=0.004) and mental (MCS: 4712 versus 4911, P=0.005) health status at the time of presentation. At 12-months, women still reported a poorer overall PCS score (4112 versus 4611, P=0.006) and MCS score (4214 versus 4912, P=0.002). Female gender was an independent determinant of a poorer baseline and 12-month PCS and MCS scores. However, there were no significant differences by gender on either mortality (unadjusted hazard ratio [HR]=0.93, 95 % CI 0.60;1.44, P=0.74) or major adverse events (unadjusted HR=0.90, 95 % CI 0.63;1.29, P=0.57), after a median follow-up of 3.2 years. Conclusions-—Women’s physical and mental health status is compromised both at initial PAD diagnosis and at 12-month follow-up, despite experiencing a similar magnitude of change in their health scores throughout the first 12-months after diagnosis. ( J A