Ankle‐brachial index, arterial stiffness, and biomarkers in the prediction of mortality and outcomes in patients with end‐stage kidney disease

Otsuka, Kenichiro; Nakanishi, Koki; Shimada, Kenei; Nakamura, Haruo; Inanami, Hitoshi; Nishioka, Hiroki; Fujimoto, Kohei; Kasayuki, Noriaki; Yoshiyama, Minoru

doi:10.1002/clc.23188

Cited by 20 publications

(17 citation statements)

References 33 publications

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“…found that abnormal ABI (ABI < 0.9 or >1.4) was associated with major adverse cardiovascular events (all cause of death, acute coronary syndrome, and stroke). 24 In the present study, we found that decreased ABI level was significantly associated with IS and that those with abnormal ABI had a significantly higher risk of IS compared with those with normal ABI. The IMPACT-ABI study showed that the incidence of stroke was significantly higher in the low ABI (≤0.9) and borderline ABI (0.91–0.99) than those with normal ABI (1.00–1.40) in patients hospitalized for cardiovascular disease during a 4.8-year mean follow-up period.…”

Section: Discussionsupporting

confidence: 57%

Predictive value of ankle–brachial index for long-term events of ischemic stroke in hemodialysis patients

et al. 2020

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Objectives The ankle–brachial index is a noninvasive modality to evaluate atherosclerosis and is a predictive role for future cardiovascular events and mortality. However, few studies have evaluated its relation to long-term future ischemic stroke in hemodialysis patients. Therefore, we examined the relationship between ankle–brachial index and ischemic stroke events among hemodialysis patients in a seven-year follow-up. Methods A total of 84 patients were enrolled. Ankle–brachial index was assessed in January 2009. Primary outcomes included ischemic stroke. An ankle–brachial index < 0.9 was considered abnormal and 1.4 ≥ ankle–brachial index ≥ 0.9 to be normal ankle–brachial index. Results Mean values for ankle–brachial index were 0.98 ± 0.21at study entrance. In addition, 28 patients encountered ischemic stroke in the seven-year follow-up. In univariate Cox regression analysis, old age (hazard ratio (HR): 1.065, 95% confidence interval (CI): 1.030–1.102, p < 0.001), low seven-year averaged serum phosphate levels (HR: 0.473, 95% CI: 0.306–0.730, p = 0.001), and abnormal ankle–brachial index (HR: 0.035, 95% CI: 0.009–0.145, p < 0.001) were risk factors for ischemic stroke. In multivariate Cox regression analysis for significant variables in univariate analysis, abnormal ankle–brachial index (HR: 0.058, 95% CI: 0.012–0.279, p < 0.001) and low seven-year averaged serum phosphate levels (HR: 0.625, 95% CI: 0.404–0.968, p = 0.035) remained the risk factors for ischemic stroke. The risk of ischemic stroke was 3.783-fold in patients with abnormal ankle–brachial index compared with patients with normal ankle–brachial index (HR: 3.783, 95% CI: 1.731–8.269, p = 0.001). Conclusions These findings suggest that ankle–brachial index is an impressive predictor of future ischemic stroke among hemodialysis patients.

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Section: Discussionsupporting

confidence: 57%

Predictive value of ankle–brachial index for long-term events of ischemic stroke in hemodialysis patients

et al. 2020

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“…In Central Africa, HR estimates for low ABI (≤0.9) were 1.86 for mortality in a population aged ≥65 years, 10% of whom had diabetes and 7% whom had a history of myocardial infarction [32]. In Japan, HR estimates for abnormal ABI (<0.9 or >1.4) were 2.01 for major adverse cardiovascular events in a population with end-stage kidney disease, 38% of whom had diabetes and 28% whom had prior coronary revascularization [33]. In France, a HR for total mortality of 1.46 was reported in a population prior to coronary artery bypass grafting [34].…”

Section: Discussionmentioning

confidence: 99%

Role of Low Ankle–Brachial Index in Cardiovascular and Mortality Risk Compared with Major Risk Conditions

Alves-Cabratosa

García-Gil

Comas-Cufí

et al. 2019

JCM

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Cardiovascular prevention is of particular interest in persons with asymptomatic peripheral arterial disease. We aimed to quantify its association with mortality and cardiovascular outcomes, compared to other indicators of high risk. We performed a retrospective cohort study using the Database of the Catalan primary care system (SIDIAPQ), for 2006–2015, including 35–85-year-old patients with an ankle–brachial index (ABI) measurement, classified according to the presence of diabetes, cardiovascular disease, and low ABI (<0.9). We calculated the incidences and hazard ratios (HRs) for all-cause mortality, acute myocardial infarction, and ischemic stroke. During a median follow-up of 5.9 years, we analyzed 58,118 persons. The mean (SD) age was 66.6 (10.7) years and 53.4% were men. Compared to the reference group with no diabetes, no previous cardiovascular disease, and normal ankle–brachial index, the HR for all-cause mortality was 1.42 (1.25–1.63) in the group with low ABI, 1.35 (1.26–1.45) in those with diabetes, 1.50 (1.34–1.69) in those with previous cardiovascular disease, and 1.84 (1.68–2.01) in those with low ABI and diabetes. In conclusion, participants with low ABI showed increased mortality, acute myocardial infarction, and ischemic stroke incidence in all the subgroups. Patients with low ankle–brachial index plus diabetes presented increased mortality, acute myocardial infarction, and ischemic stroke risk, all at rates similar to those with previous cardiovascular disease.

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“…Although this study population consisted of a primary prevention cohort, peripheral artery disease, which is a robust predictor of CVD outcomes ( 54 ), may influence the accurate measure of arterial stiffness. Otsuka et al ( 54 ) reported that the ankle-brachial index (ABI) indicates peripheral artery embolism, which might affect the measurement of arterial hardness and increase the risk of cardiovascular diseases. Also, a previous study showed that patients > 60 years with carotid plaques and low ABI (ABI 0.9) have a significantly increased risk of ischemic cardiovascular disease (HR = 7.16) ( 55 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Carotid Artery Atherosclerosis and Arterial Stiffness in Cardiovascular Disease Risk: An Ongoing Prospective Study From the Kailuan Cohort

Wen

Wang

Chen

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveTo assess whether carotid artery ultrasonography and brachial-ankle pulse wave velocity (baPWV) measurement can accurately predict cardiovascular and cerebrovascular events, and all-cause mortality in patients with cardiovascular diseases (CVD).MethodsPatients from the Kailuan Study Stroke Cohort (Tangshan, China) who underwent carotid artery ultrasonography and baPWV measurement between June 2010 and June 2011 were included in this study. The effects of carotid plaque, baPWV, and their combination on cardiovascular events, including myocardial infarction (MI), cerebral ischemic stroke, cerebrovascular events, and all-cause mortality, were evaluated using Kaplan-Meier analysis and Cox proportional hazards regression.ResultsA total of 4,899 participants (59.7% males; 54.18 ± 11.52 years old) were analyzed. During a mean follow-up of 5.68 ± 0.66 years, the incidence of cardiovascular events and all-cause mortality were 4.94‰ person-years and 7.02‰ person-years, respectively; 32.8% of participants had both carotid artery atherosclerosis and increased arterial stiffness. A high baPWV alone was associated with an increased risk of CVD events [hazard ratio (HR): 2.68; 95% confidence interval (95% CI): 1.20–6.00; P = 0.007] and cerebral infarction (HR: 5.92; 95% CI: 1.76–19.93; P = 0.004), but not with MI or all-cause death. The presence of both carotid plaque and high baPWV was highly associated with an increased risk of CVD events (HR: 4.65; 95% CI: 2.06–10.45; P < 0.001) and cerebral infarction (HR: 9.21; 95% CI: 2.71–31.19; P < 0.001), but not with MI or all-cause death. Similar results were obtained by the Kaplan-Meier analyses.ConclusionThe presence of carotid plaque and high baPWV were associated with a high risk of CVD events and ischemic stroke. Moreover, the combination of carotid artery ultrasonography and baPWV measurement could predict the risk for CVD ability more accurately than a single measurement alone.

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Ankle‐brachial index, arterial stiffness, and biomarkers in the prediction of mortality and outcomes in patients with end‐stage kidney disease

Cited by 20 publications

References 33 publications

Predictive value of ankle–brachial index for long-term events of ischemic stroke in hemodialysis patients

Predictive value of ankle–brachial index for long-term events of ischemic stroke in hemodialysis patients

Role of Low Ankle–Brachial Index in Cardiovascular and Mortality Risk Compared with Major Risk Conditions

Evaluation of Carotid Artery Atherosclerosis and Arterial Stiffness in Cardiovascular Disease Risk: An Ongoing Prospective Study From the Kailuan Cohort

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