Key result
High ABI (>1.3) was associated with increased cardiovascular mortality in nonobese individuals (HR 2.2, 95% CI 1.1-4.5) but not in obese individuals (HR 0.6, 95% CI 0.2-1.7).
Why the study?
The study was conducted to assess the influence of body-mass index on the association of ankle-brachial index with mortality.
Does body mass index influence the association between abnormal ankle-brachial index (low <0.9 or high >1.3) and all-cause or cardiovascular mortality in the general US population?
Cohort (n=4,614)
Yes
Does body mass index influence the association between abnormal ankle-brachial index (low <0.9 or high >1.3) and all-cause or cardiovascular mortality in the general US population?
Answers are grounded in this paper and cite their sources.
Obesity modifies the prognostic utility of a high ankle-brachial index (>1.3), which predicts cardiovascular mortality in nonobese patients but not in obese patients, whereas a low ABI (<0.9) consistently predicts mortality regardless of BMI.
Objective To assess the influence of body-mass index (BMI) on the association of ankle-brachial index (ABI) with mortality. Patients and Methods We conducted a prospective study of National Health and Nutrition Examination Survey participants enrolled from January 1, 1999 to December 31, 2002 with BMI and ABI data available. ABI categories were <0.9 (low), 0.9 to 1.3 (reference), and >1.3 (high). BMI categories were <30 kg/m 2 (nonobese) and ≥30 kg/m 2 (obese). Cardiovascular (CV) and all-cause mortality were assessed by National Death Index records. Cox proportional-hazards models and Kaplan-Meier survival estimates were used to compare groups. Results In total, 4614 subjects were included, with mean age 56±12 years and BMI 28±6 kg/m 2 . Median follow-up was 10.3 years (interquartile range [IQR]: 9.3 to 11.4 years). Low and high ABI were present in 7% and 8%, respectively. After adjustment, low ABI was associated with increased all-cause and CV mortality in nonobese (hazard ratio [HR] 1.5, 95% CI, 1.1-2.1 for all-cause and 3.0 [1.8-5.1] for CV mortality) and obese individuals (1.8 [1.2-2.7] and 2.5 [1.2-5.6], respectively) compared with reference. High ABI was associated with increased CV mortality in nonobese (2.2 [1.1-4.5]) but not obese patients; it was not associated with all-cause mortality overall or when stratified by BMI. Conclusion In a US cohort, weight influenced the prognostic significance of high ABI. This may be related to technical factors reducing compressibility of the calf arteries in obese persons compared with those who are nonobese.
No takes yet. Share an insight, caveat, or question.
Jazayeri et al. (2019) conducted a cohort in General US population stratified by ankle-brachial index (ABI) and body mass index (BMI) (n=4,614). Abnormal ankle-brachial index (low ABI <0.9 or high ABI >1.3) stratified by obesity status (BMI <30 vs ≥30 kg/m²) vs. Reference normal ABI (0.9 to 1.3) was evaluated on Cardiovascular mortality in nonobese (BMI <30 kg/m²) individuals with high ABI (>1.3) vs normal ABI (0.9-1.3) (HR 2.2, 95% CI 1.1-4.5). High ABI (>1.3) was associated with increased cardiovascular mortality in nonobese individuals (HR 2.2, 95% CI 1.1-4.5) but not in obese individuals (HR 0.6, 95% CI 0.2-1.7).
Synapse has enriched 10 related papers. Consider them for comparative context: