Birgitta Jönelid, Björn Kragsterman, Lars Berglund, Bertil Andrén, Nina Johnston, Bertil Lindahl, Jonas Oldgren, Christina Christersson
{"title":"近期心肌梗死后的低行走障碍问卷评分可识别多血管疾病患者。","authors":"Birgitta Jönelid, Björn Kragsterman, Lars Berglund, Bertil Andrén, Nina Johnston, Bertil Lindahl, Jonas Oldgren, Christina Christersson","doi":"10.1177/2048004019841971","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether the Walking Impairment Questionnaire score could identify patients with polyvascular disease in a population with recent myocardial infarction and their association with cardiovascular events during two-year follow-up.</p><p><strong>Design: </strong>A prospective observational study.</p><p><strong>Setting: </strong>Patients admitted to the acute coronary care unit, the Department of Cardiology, Uppsala University Hospital.</p><p><strong>Participants: </strong>Patients admitted with acute Non-STEMI- or STEMI-elevation myocardial infarction.</p><p><strong>Main outcome measures: </strong>The Walking Impairment Questionnaire, developed as a self-administered instrument to assess <i>walking distance</i>, <i>speed</i>, and <i>stair climbing</i> in patients with peripheral artery disease, predicts future cardiovascular events and mortality. Two hundred and sixty-three patients with recent myocardial infarction answered Walking Impairment Questionnaire. Polyvascular disease was defined as abnormal findings in the coronary- and carotid arteries and an abnormal ankle-brachial index. The calculated score for each of all three categories were divided into quartiles with the lowest score in first quartile.</p><p><strong>Results: </strong>The lowest (worst) quartile in all three Walking Impairment Questionnaire categories was associated with polyvascular disease, fully adjusted; <i>distance</i>, odds ratio (OR) 5.4 (95% confidence interval (CI) 1.8-16.1); <i>speed</i>, OR 7.4 (95% CI 1.5-36.5); <i>stair climbing</i>, OR 8.4 (95% CI 1.0-73.6). In <i>stair climbing score</i>, patients with the lowest (worst) score had a higher risk for the composite cardiovascular endpoint compared to the highest (best) score; hazard ratio 5.3 (95% CI 1.5-19.0). The adherence to medical treatment was high (between 81.7% and 99.2%).</p><p><strong>Conclusions: </strong>The Walking Impairment Questionnaire is a simple tool to identify myocardial infarction patients with more widespread atherosclerotic disease and although well treated medically, stair climbing predicts cardiovascular events.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"8 ","pages":"2048004019841971"},"PeriodicalIF":1.4000,"publicationDate":"2019-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019841971","citationCount":"2","resultStr":"{\"title\":\"Low Walking Impairment Questionnaire score after a recent myocardial infarction identifies patients with polyvascular disease.\",\"authors\":\"Birgitta Jönelid, Björn Kragsterman, Lars Berglund, Bertil Andrén, Nina Johnston, Bertil Lindahl, Jonas Oldgren, Christina Christersson\",\"doi\":\"10.1177/2048004019841971\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate whether the Walking Impairment Questionnaire score could identify patients with polyvascular disease in a population with recent myocardial infarction and their association with cardiovascular events during two-year follow-up.</p><p><strong>Design: </strong>A prospective observational study.</p><p><strong>Setting: </strong>Patients admitted to the acute coronary care unit, the Department of Cardiology, Uppsala University Hospital.</p><p><strong>Participants: </strong>Patients admitted with acute Non-STEMI- or STEMI-elevation myocardial infarction.</p><p><strong>Main outcome measures: </strong>The Walking Impairment Questionnaire, developed as a self-administered instrument to assess <i>walking distance</i>, <i>speed</i>, and <i>stair climbing</i> in patients with peripheral artery disease, predicts future cardiovascular events and mortality. Two hundred and sixty-three patients with recent myocardial infarction answered Walking Impairment Questionnaire. Polyvascular disease was defined as abnormal findings in the coronary- and carotid arteries and an abnormal ankle-brachial index. The calculated score for each of all three categories were divided into quartiles with the lowest score in first quartile.</p><p><strong>Results: </strong>The lowest (worst) quartile in all three Walking Impairment Questionnaire categories was associated with polyvascular disease, fully adjusted; <i>distance</i>, odds ratio (OR) 5.4 (95% confidence interval (CI) 1.8-16.1); <i>speed</i>, OR 7.4 (95% CI 1.5-36.5); <i>stair climbing</i>, OR 8.4 (95% CI 1.0-73.6). In <i>stair climbing score</i>, patients with the lowest (worst) score had a higher risk for the composite cardiovascular endpoint compared to the highest (best) score; hazard ratio 5.3 (95% CI 1.5-19.0). The adherence to medical treatment was high (between 81.7% and 99.2%).</p><p><strong>Conclusions: </strong>The Walking Impairment Questionnaire is a simple tool to identify myocardial infarction patients with more widespread atherosclerotic disease and although well treated medically, stair climbing predicts cardiovascular events.</p>\",\"PeriodicalId\":30457,\"journal\":{\"name\":\"JRSM Cardiovascular Disease\",\"volume\":\"8 \",\"pages\":\"2048004019841971\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2019-04-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1177/2048004019841971\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JRSM Cardiovascular Disease\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/2048004019841971\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2019/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JRSM Cardiovascular Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/2048004019841971","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2019/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 2
摘要
目的:评估步行障碍问卷评分是否可以识别近期心肌梗死人群中的多血管疾病患者及其与两年随访期间心血管事件的关系。设计:前瞻性观察性研究。环境:患者入院急性冠状动脉护理单位，心脏病科，乌普萨拉大学医院。参与者:入院的急性非stemi或stemi抬高心肌梗死患者。主要结果测量:行走障碍问卷，作为一种自我管理的工具，用于评估外周动脉疾病患者的步行距离、速度和爬楼梯，预测未来的心血管事件和死亡率。263例近期心肌梗死患者填写了行走障碍问卷。多血管疾病被定义为冠状动脉和颈动脉的异常表现以及踝肱指数的异常。将这三个类别的计算得分分为四分位数，第一个四分位数的得分最低。结果:在所有三个步行障碍问卷类别中，最低(最差)四分位数与多血管疾病相关，完全调整;距离，优势比(OR) 5.4(95%可信区间(CI) 1.8-16.1);速度，OR 7.4 (95% CI 1.5-36.5);爬楼梯，OR为8.4 (95% CI 1.0-73.6)。在爬楼梯评分中，得分最低(最差)的患者发生复合心血管终点的风险高于得分最高(最好)的患者;风险比5.3 (95% CI 1.5-19.0)。治疗依从性高(81.7% ~ 99.2%)。结论:行走障碍问卷是一种简单的工具，可以识别心肌梗死患者更广泛的动脉粥样硬化疾病，尽管在医学上得到了很好的治疗，但爬楼梯可以预测心血管事件。
Low Walking Impairment Questionnaire score after a recent myocardial infarction identifies patients with polyvascular disease.
Objectives: To evaluate whether the Walking Impairment Questionnaire score could identify patients with polyvascular disease in a population with recent myocardial infarction and their association with cardiovascular events during two-year follow-up.
Design: A prospective observational study.
Setting: Patients admitted to the acute coronary care unit, the Department of Cardiology, Uppsala University Hospital.
Participants: Patients admitted with acute Non-STEMI- or STEMI-elevation myocardial infarction.
Main outcome measures: The Walking Impairment Questionnaire, developed as a self-administered instrument to assess walking distance, speed, and stair climbing in patients with peripheral artery disease, predicts future cardiovascular events and mortality. Two hundred and sixty-three patients with recent myocardial infarction answered Walking Impairment Questionnaire. Polyvascular disease was defined as abnormal findings in the coronary- and carotid arteries and an abnormal ankle-brachial index. The calculated score for each of all three categories were divided into quartiles with the lowest score in first quartile.
Results: The lowest (worst) quartile in all three Walking Impairment Questionnaire categories was associated with polyvascular disease, fully adjusted; distance, odds ratio (OR) 5.4 (95% confidence interval (CI) 1.8-16.1); speed, OR 7.4 (95% CI 1.5-36.5); stair climbing, OR 8.4 (95% CI 1.0-73.6). In stair climbing score, patients with the lowest (worst) score had a higher risk for the composite cardiovascular endpoint compared to the highest (best) score; hazard ratio 5.3 (95% CI 1.5-19.0). The adherence to medical treatment was high (between 81.7% and 99.2%).
Conclusions: The Walking Impairment Questionnaire is a simple tool to identify myocardial infarction patients with more widespread atherosclerotic disease and although well treated medically, stair climbing predicts cardiovascular events.
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