Different Calculations of Ankle-Brachial Index and Their Impact on Cardiovascular Risk Prediction

Espinola‐Klein, Christine; Rupprecht, Hans J.; Bickel, Christoph; Lackner, Karl J.; Savvidis, Savvas; Messow, Claudia-Martina; Münzel, Thomas; Blankenberg, Stefan

doi:10.1161/circulationaha.107.763227

Cited by 189 publications

(133 citation statements)

References 29 publications

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“…The ankle brachial index was calculated by dividing the lower ankle SBP by the higher brachial SBP. 10 An ankle brachial index of ≤0.90 in either leg was considered to indicate peripheral arterial disease. The estimated glomerular filtration rate was determined using the four-variable Modification of Diet in Renal Disease Study equation.…”

Section: Measurements and Definitionsmentioning

confidence: 99%

Screening for cardiovascular risk factors and self-rated health in a community setting: a cross-sectional study in Finland

2014

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Section: Measurements and Definitionsmentioning

confidence: 99%

Screening for cardiovascular risk factors and self-rated health in a community setting: a cross-sectional study in Finland

2014

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“…The modified ABI has been suggested as a more sensitive measure for identifying patients with cardiovascular risk than the conventional method. 45,46 However, this sensitivity comes at the cost of specificity, 46 and thus the modified ABI might be less suitable as a screening method in general practice among a population with a lower PAD prevalence than the populations studied by Espinola-Klein et al 45 and Schröder et al 46 As a result of the higher oscillometric ABI values, some investigators used receiver operating characteristics analysis to propose the use of a higher oscillometric ABI cutoff value for PAD diagnosis, varying Automated ankle-brachial index assessment WJ Verberk et al from 0.92 to 1.04. 7,19,32 Therefore, the use of a higher oscillometric ABI threshold close to 1.0 is expected to increase the diagnostic accuracy of PAD.…”

Section: Automated Ankle-brachial Index Assessment Wj Verberk Et Almentioning

confidence: 99%

Automated oscillometric determination of the ankle-brachial index: a systematic review and meta-analysis

2012

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Measurement of the ankle-brachial index (ABI) using a Doppler device is widely used to identify subjects with peripheral artery disease (PAD), and those who are at high risk of cardiovascular disease. This paper presents a systematic review (Medline/ PubMed, Embase and Cochrane) and meta-analysis of studies assessing the usefulness of automated oscillometric devices for ABI estimation and PAD detection compared with the conventional Doppler method. A total of 25 studies including 4186 subjects were analyzed. A random-effects model analysis showed that the average oscillometric ABI was similar to the Doppler ABI (mean difference ± s.e. 0.020 ± 0.018, P ¼ 0.3) but that the absolute differences were significant (0.048 ± 0.009, Po0.01). The pooled correlation coefficient (r) between the oscillometric and Doppler ABI was 0.71 ± 0.05. Simultaneous arm-leg measurements resulted in a smaller difference between the average oscillometric ABI value and the average Doppler ABI value than did sequential measurements ( À0.012 ± 0.022 vs. 0.040 ± 0.026, respectively, Po0.01). The average sensitivity and specificity of the oscillometric ABI estimation in PAD diagnosis was 69 ± 6% and 96 ± 1%, respectively (with Doppler ABI taken as the reference). These data suggest that an automated ABI measurement obtained by oscillometric blood pressure monitors is a reliable and practical alternative to the conventional Doppler measurement for the detection of PAD.To increase the sensitivity of the PAD diagnosis based on an oscillometric ABI, a higher threshold of 1.0 might be preferable.

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“…The patients lied in supine position after resting at normal room temperature; measurements were taken at each ankle over the posterior tibial and dorsal pedal arteries. ABI was calculated as the lowest pressure of the ankles divided by the higher of the left and right arm pressures (Espinola-Klein et al 2008;Fowkes et al 2008). Carotid IMT and the noncardiac part of the general calcification score was determined by a single experienced radiologist who was blinded to patients' clinical information.…”

Section: Study Populationmentioning

confidence: 99%

Serum level of soluble Hsp70 is associated with vascular calcification

Krepuska¹,

Szeberin²,

Sótonyi³

et al. 2011

Cell Stress and Chaperones

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It has been previously reported that serum levels of 70-kDa heat shock protein (Hsp70) are elevated in peripheral artery disease. The aim of the present study was to examine whether increased serum Hsp70 levels are related to the extent of arterial calcification and standard laboratory parameters of patients with peripheral artery disease, as well as to markers of inflammation (C-reactive protein), atherosclerosis (homocysteine), and calcification (fetuin-a). One hundred eighty chronic atherosclerotic patients with significant carotid stenosis and/or lower extremity vascular disease were enrolled in this crosssectional study. Systemic atherosclerosis and calcification was assessed by ultrasound (carotid intima-media thickness (IMT), presence of calcification at the abdominal aorta, carotid and femoral bifurcations, and aortic and mitral cardiac valves). Standard serum markers of inflammation, diabetes, renal function, ankle-brachial indexes, and traditional risk factors for atherosclerosis were noted. Serum Hsp70 levels were measured with enzyme-linked immunosorbent assay. Standard laboratory parameters (clinical chemistry), C-reactive protein (CRP), and homocysteine levels were determined by an autoanalyzer using the manufacturer's kits. Fetuin-a levels were measured by radial immunodiffusion. Patients' median age was 64 (57-71) years, 69% were men, and 34.5% had diabetes. Serum heat shock protein 70 levels were significantly higher in patients with more severe arterial calcification (p< 0.02) and showed significant positive correlations with serum bilirubin (r=0.23, p=0.002) and homocysteine levels (r= 0.18, p=0.02). Serum Hsp70 did not correlate with body mass index, IMT, CRP, or fetuin-a levels in this cohort. Logistic regression analysis confirmed the association between sHsp70 and calcification score (OR, 2.189; CI, p=0.016) and this correlation remained significant (OR, 2.264; CI, 1.021-5.020, p=0.044) after the adjustment for age, sex, eGFR, smoking, CRP, and homocysteine levels. Our data show that serum Hsp70 levels correlate with the severity of atherosclerosis in patients with carotid artery disease and chronic lower limb ischemia. These data support a putative role for plasma Hsp70 in the development of arterial calcification. Nevertheless, further studies are required to investigate the usefulness of circulating Hsp70 level as a marker of atherosclerotic calcification.

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Different Calculations of Ankle-Brachial Index and Their Impact on Cardiovascular Risk Prediction

Cited by 189 publications

References 29 publications

Screening for cardiovascular risk factors and self-rated health in a community setting: a cross-sectional study in Finland

Screening for cardiovascular risk factors and self-rated health in a community setting: a cross-sectional study in Finland

Automated oscillometric determination of the ankle-brachial index: a systematic review and meta-analysis

Serum level of soluble Hsp70 is associated with vascular calcification

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