Association of 6-Minute Walk Performance and Physical Activity With Incident Ischemic Heart Disease Events and Stroke in Peripheral Artery Disease

Background: we determined whether poorer 6-minute walk performance and lower physical activity levels are associated with higher rates of ischemic heart disease (ihd) events in people with lower extremity peripheral artery disease (pad).methods and results: five hundred ten pad participants were identified from chicago-area medical centers and followed prospectively for 19.0±9.5 months. at baseline,participants completed the 6-minute walk and reported number of blocks walked during the past week (physical activity). ihd events were systematically adjudicated and consisted of new myocardial infarction,unstable angina,and cardiac death. for 6-minute walk,ihd event rates were 25/170 (14.7%) for the third (poorest) tertile,10/171 (5.8%%) for the second tertile,and 6/169 (3.5%) for the first (best) tertile (p=0.003). for physical activity,ihd event rates were 21/154 (13.6%) for the third (poorest) tertile,15/174 (8.6%) for the second tertile,and 5/182 (2.7%) for the first (best) tertile (p=0.001). adjusting for age,sex,race,smoking,body mass index,comorbidities,and physical activity,participants in the poorest 6-minute walk tertile had a 3.28-fold (95% ci 1.17 to 9.17,p=0.024) higher hazard for ihd events,compared with those in the best tertile. adjusting for confounders including 6-minute walk,participants in the poorest physical activity tertile had a 3.72-fold (95% ci 1.24 to 11.19,p=0.019) higher hazard for ihd events,compared with the highest tertile.conclusions: six-minute walk and physical activity predict ihd event rates in pad. further study is needed to determine whether interventions that improve 6-minute walk,physical activity,or both can reduce ihd events in pad. © 2015 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.