Clinical Characteristics and Outcomes of Patients with High Ankle-Brachial Index from the IMPACT-ABI Study

Abstract

BackgroundReduced ankle–brachial index (ABI) is a predictor of cardiovascular events. However, the significance of high ABI remains poorly understood. This study aimed to assess the characteristics and outcomes of patients with high ABI.MethodsThe IMPACT-ABI study was a retrospective cohort study that enrolled and examined ABI in 3,131 patients hospitalized for cardiovascular disease between January 2005 and December 2012. From this cohort, 2,419 patients were identified and stratified into two groups: high ABI (> 1.4; 2.6%) and normal ABI (1.0–1.4; 97.3%). The primary endpoint was the cumulative incidence of major adverse cardiovascular events (MACE), including cardiovascular-associated death, myocardial infarction, and stroke.ResultsCompared with the normal ABI group, patients in the high ABI group showed significantly lower body mass index (BMI) and hemoglobin level, but had higher incidence of chronic kidney disease and hemodialysis. Multivariate logistic regression analysis revealed that hemodialysis was the strongest predictor of high ABI (odds ratio, 6.18; 95% confidence interval (CI), 3.05–12.52; P < 0.001). During the follow-up (median, 4.7 years), 172 cases of MACE occurred. Cumulative MACE incidence in patients with high ABI was significantly increased compared to that in those with normal ABI (32.5% vs. 14.5%; P = 0.005). In traditional cardiovascular risk factors-adjusted multivariate Cox proportional hazard analysis, high ABI was an independent predictor of MACE (hazard ratio, 2.07; 95% CI, 1.02–4.20; P = 0.044).ConclusionLower BMI, chronic kidney disease, and hemodialysis are more frequent in patients with high ABI. Hemodialysis is the strongest predictor of high ABI. High ABI is a parameter that independently predicts MACE.

Ankle brachial index and cognitive function among Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos

“…Work linking high ABI to cerebrovascular events (e.g. stroke) is less clear, however; for example, some work shows no evidence [34] or crude only associations [35] whereas others report higher risk and hazards for cerebrovascular events [36,37]. …”

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

“…We characterized the population and included potential modifiers of the low ABI association with all-cause mortality, AMI, and IS [5,21,22,23,24,25,26], describing age, sex, smoking habit, continuous variables: body mass index (BMI) -calculated as weight divided by squared height-, systolic and diastolic blood pressure (BP), pulse pressure, low (LDL) and high (HDL) density lipoprotein cholesterol, triglycerides; we considered the last record up to one year previous to entry date (72% to 85% of the population had a record up to 6 months previous to entry date). We also described the following comorbidities: hypertension, atrial fibrillation, malignant neoplasms, chronic kidney disease, and chronic obstructive pulmonary disease.…”

Geriatric Nutritional Risk Index Predicts Cardiovascular Events in Patients at Risk for Heart Failure

“…Details of the IMPACT-ABI study have been published. [14][15][16][17] In summary, we retrospectively identified 4,619 consecutive patients who were admitted to the Department of Cardiology at Shinshu University Hospital for any CV disease between January 2005 and December 2012. Of these, 1,488 patients were excluded because of missing ABI data, and the remaining 3,131 patients were enrolled in the IMPACT-ABI study.…”