Key result
Low and borderline ankle-brachial index significantly increased the risk of major adverse cardiovascular events compared to normal ABI (HR 1.93 and HR 1.54, respectively) in hospitalized cardiology patients.
Why the study?
Does low or borderline ankle-brachial index increase the risk of major adverse cardiovascular events in patients hospitalized for cardiovascular disease?
Cohort (n=3,056)
No
Does low or borderline ankle-brachial index increase the risk of major adverse cardiovascular events in patients hospitalized for cardiovascular disease?
Both low and borderline ankle-brachial index are independent predictors of long-term adverse cardiovascular events, including stroke and heart failure, in hospitalized cardiology patients.
Answers are grounded in this paper and cite their sources.
Supports routine ABI screening for risk stratification in hospitalized cardiovascular patients; leaves open whether ABI-guided.
BACKGROUND: The ankle-brachial index (ABI) is a marker of generalized atherosclerosis and is predictive of future cardiovascular events. However, few studies have assessed its relation to long-term future cardiovascular events, especially in patients with borderline ABI. We therefore evaluated the relationship between long-term future cardiovascular events and ABI. METHODS: In the IMPACT-ABI study, a single-center, retrospective cohort study, we enrolled 3131 consecutive patients (67 ± 13 years; 82% male) hospitalized for cardiovascular disease and measured ABI between January 2005 and December 2012. After excluding patients with an ABI > 1.4, the remaining 3056 patients were categorized as having low ABI (≤ 0.9), borderline ABI (0.91-0.99), or normal ABI (1.00-1.40). The primary endpoint was MACE (cardiovascular death, myocardial infarction [MI] and stroke). The secondary endpoints were cardiovascular death, MI, stroke, admission due to heart failure, and major bleeding. RESULTS: During a 4.8-year mean follow-up period, the incidences of MACE (low vs. borderline vs. normal: 32.9% vs. 25.0% vs. 14.6%, P<0.0001) and cardiovascular death (26.2% vs. 18.7% vs. 8.9%, P<0.0001) differed significantly across ABIs. The incidences of stroke (9.1% vs. 8.6% vs. 4.8%, P<0.0001) and heart failure (25.7% vs. 20.8% vs. 8.9%, P<0.0001) were significantly higher in the low and borderline ABI groups than in the normal ABI group. But the incidences of MI and major bleeding were similar in the borderline and normal ABI groups. The hazard ratios for MACE adjusted for traditional atherosclerosis risk factors were significantly higher in patients with low and borderline ABI than those with normal ABI (HR, 1.93; 95%CI: 1.44-2.59, P < 0.0001, HR, 1.54; 95% CI: 1.03-2.29, P = 0.035). CONCLUSIONS: The incidence of long-term adverse events was markedly higher among patients with low or borderline ABI than among those with normal ABI. This suggests that more attention should be paid to patients with borderline ABIs, especially with regard to cardiovascular death, stroke, and heart failure.
No takes yet. Share an insight, caveat, or question.
Miura et al. (2017) conducted a cohort in Cardiovascular disease (n=3,056). Low ankle-brachial index (≤0.9) vs. Normal ankle-brachial index (1.00-1.40) was evaluated on Major adverse cardiovascular events (MACE: cardiovascular death, myocardial infarction, and stroke) (HR 1.93, 95% CI 1.44-2.59, p=<0.0001). Low and borderline ankle-brachial index significantly increased the risk of major adverse cardiovascular events compared to normal ABI (HR 1.93 and HR 1.54, respectively) in hospitalized cardiology patients.
Synapse has enriched 10 related papers. Consider them for comparative context: