einstein (São Paulo). 11/set/2025;23:eAO1611.

Mortality rate in patients with symptomatic peripheral artery disease in Brazil: comparison between sexes

Breno Quintella

Farah

, Raphael Mendes

Ritti-Dias

, Raquel Santana

Fernandes

, Antonio Eduardo

Zeratti

, Nelson

Wolosker

, Gabriel Grizzo

Cucato

, Marilia de Almeida

Correia

, Hélcio

Kanegusuku

DOI: 10.31744/einstein_journal/2025AO1611

Highlights

■ A total of 58.1% of the patients died during a mean follow-up period of approximately 5.2 years.
■ Cardiovascular diseases are the main cause of death in these patients.
■ Men had a higher likelihood of death from all causes than women.
■ No difference was found between the sexes in relation to the different causes of death.

ABSTRACT

Objective:

To compare mortality rates between sexes in a cohort of patients with intermittent claudication residing in a metropolitan city in Brazil.

Methods:

In this study, we included 215 patients (mean age 67±10 years, 65.3% men) who were followed for an average of 5.2 years (95% confidence interval [95%CI]: 4.8-5.5 years). At baseline, sociodemographic data, comorbidities, and clinical characteristics were recorded. The six-minute walk test was administered, with results reported as both absolute and relative walking distances, the latter based on reference values for healthy individuals with similar characteristics. Deaths were documented throughout the follow-up period. Cox regression analysis was used to estimate hazard ratios (HRs) and 95%CIs, adjusting for potential confounding factors.

Results:

A total of 105 patients (58.9% men) died, with cardiovascular diseases accounting for the leading cause of death (32.0%). Deceased patients were older, had a higher prevalence of hypertension, and demonstrated shorter absolute and relative walking distances. Men had a significantly higher risk of all-cause mortality compared to women, independent of age, chronic obstructive pulmonary disease, six-minute walking distance, and ankle-brachial index (HR: 2.774; 95%CI= 1.316-5.847).

Conclusion:

In patients with peripheral artery disease, men with intermittent claudication symptoms exhibit a higher risk of all-cause mortality compared to women. Future research should focus on identifying sex-specific risk factors associated with mortality in this population. Such insights are critical for developing targeted interventions aimed at reducing mortality, particularly among men with intermittent claudication in low- and middle-income countries.

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