Ankle-brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease

Papamichael, Christos; Lekakis, John; Stamatelopoulos, Kimon; Παπαϊωάννου, Θεόδωρος; Alevizaki, Maria; Cimponeriu, Adriana; Kanakakis, John; Papapanagiotou, Angeliki; Kalofoutis, Anastasios; Stamatelopoulos, Stamatios

doi:10.1016/s0002-9149(00)01038-9

Cited by 200 publications

(160 citation statements)

References 25 publications

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“…Prior analysis of CHS has shown that subclinical carotid disease is closely related to prevalent and incident heart disease (3,15). Other studies have shown a significant inverse relationship between carotid wall disease and AAI (16). Carotid disease can therefore be considered a marker of subclinical atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Clinical and Isolated Subclinical Cardiovascular Disease in Older Adults With Glucose Disorders

et al. 2001

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OBJECTIVE -Clinical cardiovascular disease (CVD) is highly prevalent among people with diabetes. However, there is little information regarding the prevalence of subclinical CVD and its relation to clinical CVD in diabetes and in the glucose disorders that precede diabetes. RESEARCH DESIGN AND METHODS -Participants in the Cardiovascular HealthStudy, aged Ն65 years (n ϭ 5,888), underwent vascular and metabolic testing. Individuals with known disease in the coronary, cerebral, or peripheral circulations were considered to have clinical disease. Those without any clinical disease in whom CVD was detected by ultrasonography, electrocardiography, or ankle arm index in any of the three vascular beds were considered to have isolated subclinical disease.RESULTS -Approximately 30% of the cohort had clinical disease, and ϳ60% of the remainder had isolated subclinical disease. In those with normal glucose status, isolated subclinical disease made up most of the total CVD. With increasing glucose severity, the proportion of total CVD that was clinical disease increased; 75% of men and 66% of women with normal fasting glucose status had either clinical or subclinical CVD. Among those with known diabetes, the prevalence was ϳ88% (odds ratio [OR] 2.46 for men and 4.22 for women, P Ͻ 0.0001). There were intermediate prevalences and ORs for those with impaired fasting glucose status and newly diagnosed diabetes.CONCLUSIONS -Isolated subclinical CVD is common among older adults. Glucose disorders are associated with an increased prevalence of total CVD and an increased proportion of clinical disease relative to subclinical disease.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Clinical and Isolated Subclinical Cardiovascular Disease in Older Adults With Glucose Disorders

et al. 2001

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“…17 Questions 1-5 and 15 of the IIEF constitute the erectile function domain, which is used to assess global erectile function. Scoring the IIEF domain of erectile function allowed the classification of each patient as follows: absent of ED (26)(27)(28)(29)(30), mild ED (17)(18)(19)(20)(21)(22)(23)(24)(25), moderate ED (11)(12)(13)(14)(15)(16) and severe ED (0-10).…”

Section: Methodsmentioning

confidence: 99%

“…13,14 As MS has been found to be associated with atherosclerotic ischemic heart disease, ED also shows a strong association with several classic risk factors for CAD, particularly DM, current smoking status and hypertension. 15,16 Therefore, MS and ED could be related.…”

Section: Introductionmentioning

confidence: 99%

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity

Chu

et al. 2009

Int J Impot Res

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We determined the association between the severity of erectile dysfunction (ED) and traditional cardiovascular risk factors, including metabolic syndrome (MS). A total of 141 ED patients were divided into three groups on the basis of ED severity, which was determined using the International Index of Erectile Function (IIEF) scores. The prevalence of MS among the ED patients was 32.6%. Significantly lower IIEF scores were noted in patients with MS than in patients without MS (7.6±6.4 vs 11.6±7.4, P ¼ 0.003). As assessed by the anthropometric indices of body mass index, waist circumference and waist-to-hip ratio, obesity was detected in 58.9, 54.6 and 32.6% of the patients, respectively. Of the 141 patients, 39 had mild, 24 had moderate and 78 had severe ED. Statistically significant differences were noted among the different ED severity groups with regard to the presence of hypertension, systolic blood pressure, presence of MS and number of MS components. Multivariate analysis showed that the odds ratio for high-low-density lipoprotein (LDL) cholesterol level in moderate and severe ED, determined with reference to mild ED, were 9.346 and 6.452, respectively. The presence of MS, number of MS components, and certain traditional cardiovascular risk factors, particularly high-LDL cholesterol level and hypertension, may influence the severity of ED.

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“…An ankle-brachial index (ABI) <1.00 is therefore abnormal, although a cut off <0.90 or <0.95 has greater specificity and is used to make the diagnosis of peripheral arterial disease (PAD) in the clinical setting. ABI is a simple, noninvasive method used to assess the presence and extent of PAD [2], and prospective studies have shown that a low ABI predicts fatal and non fatal coronary heart disease (CHD) and all cause mortality [3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Aortic augmentation index is associated with the ankle-brachial index: A community-based study

Khaleghi

Kullo

2007

Atherosclerosis

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Background-Increased arterial stiffness has been associated with greater risk of cardiovascular events. We investigated whether aortic augmentation index (AIx), a measure of arterial stiffness and wave reflection, was associated with the ankle-brachial index (ABI), a measure of peripheral arterial disease (PAD).Method-AIx and ABI were measured in a community-based sample of 475 adults without prior history of heart attack or stroke (mean age 59.3 years, 46.5% men). Radial artery pulse waveforms were obtained by applanation tonometry and an ascending aortic pressure waveform derived by a transfer function. AIx is the difference between the first and second systolic peak of the ascending aortic pressure waveform indexed to the central pulse pressure. ABI was measured using a standard protocol, and subjects with non-compressible vessels (ABI >1.5) were excluded from the analyses. Multivariable linear and logistic generalized estimating equations (GEE) analyses were used to assess whether AIx was associated with ABI and ABI <1.00 respectively, independent of conventional risk factors.Results-Mean (± SD) values were: AIx, 29.3±11.6 %; ABI, 1.12±0.13; 59 (12.4%) participants had an ABI <1.00. Variables associated with a lower ABI (and ABI <1.00) included older age, shorter height, female sex, higher total cholesterol, hypertension medication use, history of smoking, and higher AIx. After adjustment for mean arterial pressure and the above variables, higher AIx remained associated with a lower ABI (P=0.015) and ABI <1.00 (P=0.002). A significant interaction (P=0.007) was present between AIx and age in the prediction of ABI; the (inverse) association of AIx with ABI was stronger in older subjects (>65 years).Conclusion-AIx, a measure of arterial stiffness and wave reflection, was independently associated with a lower ABI in asymptomatic subjects from the community, and this association was modified by age.

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Ankle-brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease

Cited by 200 publications

References 25 publications

Prevalence of Clinical and Isolated Subclinical Cardiovascular Disease in Older Adults With Glucose Disorders

Prevalence of Clinical and Isolated Subclinical Cardiovascular Disease in Older Adults With Glucose Disorders

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity

Aortic augmentation index is associated with the ankle-brachial index: A community-based study

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