Low Walking Impairment Questionnaire score after a recent myocardial infarction identifies patients with polyvascular disease

Abstract

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.