For patients with intermittent claudication (IC) who have either not responded to a supervised regimen of exercise and medication, or have specifically requested more aggressive treatment to improve their quality of life, revascularization strategy is generally decided based on anatomical considerations and the availability of a saphenous vein graft. Most guidelines now recommend endovascular treatment (EVT) for short lesions in the femoropopliteal (FP) area, as short-term EVT outcomes have improved because of technological advances. This is the case even for long FP lesions when no saphenous vein is available. Although the prognosis of patients with IC is generally good, life expectancy of individual patients varies based on their comorbidities and disease history. Patients with longer life expectancy should undergo more durable revascularization, even if it is invasive. Therefore, prediction of life expectancy can assist revascularization decision-making in patients with IC. Frailty is a clinical syndrome characterized by a decline in physical activity or cognitive function that leads to a poor prognosis.

Previous reports have shown the influence of frailty on revascularization outcomes in patients with critical limb-threatening ischemia (CLTI). However, the use of the 11-item modified frailty index (mFI-11) to predict outcomes in patients with IC resulting from peripheral arterial disease (PAD) has not been examined, likely because patients expected to be frail with IC rarely undergo revascularization. The mFI-11, which was created to estimate patient frailty, consists of various risk factors related to PAD, and may be an appropriate tool to predict outcome after revascularization for IC. This study is aimed to investigate mFI-11's determination of frailty and comorbid status in relation to the predicted outcomes, or prognoses, of IC patients in order to facilitate the better selection of a revascularization strategy.

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Mishita
Jornal co-ordinator
Journal of Heart and Cardiovascular Research