{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:58:03Z","timestamp":1793426283419,"version":"4.5.0"},"reference-count":59,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec id=\"jah311048-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">While peripheral artery disease care for claudication aims to improve health status (symptoms, physical function, and quality of life), health status trajectories remain unclear. We aimed to determine health status trajectories and explore baseline factors associated with treatment nonresponsiveness.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah311048-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Data were derived from the PORTRAIT (Patient\u2010Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) registry of patients with claudication symptoms presenting to vascular specialty clinics across the United States, Australia, and Netherlands. The Peripheral Artery Questionnaire was used to measure the health status at baseline and 3, 6, and 12\u2009months. Latent trajectory modeling enabled the classification of patients into latent Peripheral Artery Questionnaire trajectory subgroups over 12\u2009months. These subgroups were categorized as \u201cresponsive\u201d or \u201cnonresponsive,\u201d depending on whether the 12\u2010month increase in mean Peripheral Artery Questionnaire score was greater than or equal to the clinically meaningful threshold of 10 or not, respectively. Sequential hierarchical multivariable logistic regression assessed baseline factors associated with a nonresponsive versus responsive trajectory.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah311048-sec-0003\" xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">The cohort was composed of 1204 patients (62.5% men and aged 67.5\u00b19.4\u2009years). Five latent trajectory subgroups were identified: consistently high (33.3%), high maintained (8.1%), high transient (12.9%), moderate maintained (33.2%), and consistently low response (12.5%) with mean Peripheral Artery Questionnaire improvements of +16.8, +59.4, +7.6, +24.0, and +8.6, respectively. Nonresponsive clinical trajectory was associated with prior cerebrovascular accident, sleep apnea, alcohol use disorder, and worse depressive symptoms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah311048-sec-0004\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Individuals with claudication display heterogenous recovery trajectories. Roughly 25% experienced no health status response at 12\u2009months after treatment, which was associated with medical and psychosocial factors. Further emphasis should be placed on a biopsychosocial model of peripheral artery disease care.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039455","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T05:49:34Z","timestamp":1750225774000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Latent Health Status Trajectories in Individuals With New or Worsening Claudication Symptoms"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1228-1578","authenticated-orcid":false,"given":"Scott","family":"Grubman","sequence":"first","affiliation":[{"name":"Vascular Medicine Outcomes Program, Yale School of Medicine","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4294-5507","authenticated-orcid":false,"given":"Ga\u00eblle","family":"Romain","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program, Yale School of Medicine","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6143-0237","authenticated-orcid":false,"given":"Jacob","family":"Cleman","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program, Yale School of Medicine","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1338-0589","authenticated-orcid":false,"given":"Lindsey","family":"Scierka","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program, Yale School of Medicine","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Pajarillo","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program, Yale School of Medicine","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7954-4400","authenticated-orcid":false,"given":"Jonathan","family":"Kluger","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program, Yale School of Medicine","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4954-5672","authenticated-orcid":false,"given":"Carlos","family":"Mena\u2010Hurtado","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program, Yale School of Medicine","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6104-6254","authenticated-orcid":false,"given":"Kim G.","family":"Smolderen","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program, Yale School of Medicine","place":["New Haven, USA"]},{"name":"Yale School of Medicine","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30255-4"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012177"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2006.06.008"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000470"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.12.006"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.05.042"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.075770"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2006.08.007"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/circinterventions.121.011506"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.119.008450"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2001.119749"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.117.003860"},{"key":"e_1_3_1_14_2","unstructured":"Grubman S. 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