Mortality and Cardiovascular Risk Across the Ankle-Arm Index Spectrum

O’Hare, Ann M.; Katz, Ronit; Shlipak, Michael G.; Cushman, Mary; Newman, Anne B.

doi:10.1161/circulationaha.105.570903

Cited by 281 publications

(235 citation statements)

References 36 publications

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“…Using data from the Strong Heart Study 23) , they reported that the adjusted hazards ratio of ABI ＞1.4 was 1.77 (95%CI 1.48-2.13) for all-cause mortality and 2.08 (95%CI 1.49-2.94) for cardiovascular mortality. This association was confirmed by another cohort study [24][25][26] . It is suggested that high ABI could be related to poor arterial compressibility resulting from stiffness and calcification 26) .…”

Section: Resultssupporting

confidence: 59%

The Association between Changes in Urinary Albumin-to-Creatinine Ratio and Risk of Abnormal Ankle-Brachial Index in a Community-Based Chinese Population

Niu

Zhang

Wang

et al. 2012

JAT

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Aims:To investigate the prospective association between changes in the urinary albumin-creatinine ratio (ACR) and abnormal ankle-brachial index (ABI) in a community-based Chinese population. Methods: This prospective cohort study included 799 residents aged 58.3±9.2 years and without a history of cardiovascular disease from an urban district of Beijing, China. Urinary ACR was measured at baseline, and at 4 and 6 years of follow-up. The 75th percentile of the baseline urinary ACR (5.82 mg/g) was used to define "high" ACR. The changes in urinary ACR were categorized as consistently low urinary ACR, intermittent high urinary ACR, and consistently high urinary ACR. ABI was measured at 6 years of follow-up. Multinomial logistic regression was used to evaluate the associations of changes in urinary ACR categories with the ABI categories. Results: During 6 years of follow-up, 16.1% of participants (n = 128) had low ABI and 13.9% of participants (n = 111) had high ABI. After adjusting for potential confounders including baseline albuminuria, individuals who had consistently high urinary ACR or intermittent high urinary ACR had a significantly higher risk for low ABI than individuals who had consistently low urinary ACR, with odds ratios (OR) of 2.75 (95%CI, 1.37-5.52) and 2.06 (95%CI, 1.18-3.57), respectively. No independent association was observed between changes in urinary ACR and high ABI among participants. Conclusion: Changes in urinary ACR below the definition for albuminuria predict low ABI among this community-based population without a history of cardiovascular disease. J Atheroscler Thromb, 2012; 19:912-917.

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Section: Resultssupporting

confidence: 59%

The Association between Changes in Urinary Albumin-to-Creatinine Ratio and Risk of Abnormal Ankle-Brachial Index in a Community-Based Chinese Population

Niu

Zhang

Wang

et al. 2012

JAT

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“…Previous studies in non‐CKD patients suggested that ABI of 0.9 to <1.0 predicted CVD and total mortality 6, 24. The American Heart Association (AHA) suggested that ABI should be interpreted according to the a priori probability of PAD, and values between 0.91 and 1.00 should be considered borderline 25.…”

Section: Discussionmentioning

confidence: 99%

Ankle Brachial Index and Subsequent Cardiovascular Disease Risk in Patients With Chronic Kidney Disease

Chen

Mohler

Garimella

et al. 2016

JAHA

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BackgroundThe clinical implications of ankle‐brachial index (ABI) cutpoints are not well defined in patients with chronic kidney disease (CKD) despite increased prevalence of high ABI attributed to arterial stiffness. We examined the relationship of ABI with cardiovascular disease (CVD) and all‐cause mortality among CKD patients.Methods and ResultsThree thousand six hundred twenty‐seven participants without clinical peripheral artery disease (PAD) at baseline from the Chronic Renal Insufficiency Cohort Study were included. ABI was obtained per standard protocol and CVD events were confirmed by medical record adjudication. A U‐shaped association of ABI with PAD, myocardial infarction (MI), composite CVD, and all‐cause mortality was observed. Individuals with an ABI between 1.0 and <1.4 had the lowest risk of outcomes. Compared to participants with an ABI between 1.0 and <1.4, multiple‐adjusted hazard ratios (95% confidence intervals) for those with an ABI of <0.9, 0.9 to <1.0, and ≥1.4 were 5.78 (3.57, 9.35), 2.76 (1.56, 4.88), and 4.85 (2.05, 11.50) for PAD; 1.67 (1.23, 2.29), 1.85 (1.33, 2.57), and 2.08 (1.10, 3.93) for MI; 1.51 (1.27, 1.79), 1.39 (1.15, 1.68), and 1.23 (0.82, 1.84) for composite CVD; and 1.55 (1.28, 1.89), 1.36 (1.10, 1.69), and 1.00 (0.62, 1.62) for all‐cause mortality, respectively.ConclusionsThis study indicates that ABI <1.0 was related to risk of PAD, MI, composite CVD, and all‐cause mortality whereas ABI ≥1.4 was related to clinical PAD. These findings suggest that ABI cutpoints of <1.0 or ≥1.4 for diagnosing PAD and ABI <1.0 for CVD risk stratification should be further evaluated among CKD patients.

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“…a value lower than 0.9 is diagnostic of the disease, which is a synonym for high cardiovascular risk and mortality [4,34] PAD is an important predictor of cardiovascular morbidity and mortality [38], independent of age, sex and the presence of different CRF [39]. In this study the presence of PAD is signifi cantly associated with smoking, hypertension, DM, DL and obesity.…”

Section: Resultsmentioning

confidence: 63%

Peripheral arterial disease and cardiovascular risk. The importance of Doppler in multi-pathological population

Asenjo¹,

Guerra²,

Martin³

et al. 2017

Ann Circ

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Objective: The aim of this study is to calculate cardiovascular risk (CVR), vascular age (VA), and prevalence of peripheral arterial disease (PAD) in the multi-pathological population admitted to Internal Medicine services, as well as to study the relationship between PAD and Mönckeberg's calcifi cation with VA and cardiovascular risk factors (CRF) in this population. Material and method:Cross-sectional observational study, including multi-pathological patients admitted to Internal Medicine, excluding those with diagnosed PAD. Demographic variables, anklebrachial index (ABI), presence of multi-pathology, CRF present, CVR measured by SCORE and VA were recorded.Results: 414 patients were included: 54.8% were men and 45.2% were women. The most prevalent pathology was heart failure followed by chronic respiratory insuffi ciency, ischemic heart disease and chronic anaemia secondary to digestive bleeding. 25.3% of patients have PAD, which is signifi cantly associated with ischemic heart disease and type 2 diabetes mellitus with target organ injuries. 21.2% of the sample suffers from Mönckeberg calcifi cation and in 53.5 the ABI is normal. CVR and VA were calculated in patients younger than 65 years (22.16%), PAD was associated with SCORE> 5% and a high VA. Conclusion:This study highlights the importance of the determination of ABI, CVR and VA in patients admitted to Internal Medicine services. Since PAD is in the majority of cases asymptomatic and, therefore, underdiagnosed, its presence forces us to a comprehensive treatment of the patient to avoid any of these events.

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Mortality and Cardiovascular Risk Across the Ankle-Arm Index Spectrum

Cited by 281 publications

References 36 publications

The Association between Changes in Urinary Albumin-to-Creatinine Ratio and Risk of Abnormal Ankle-Brachial Index in a Community-Based Chinese Population

The Association between Changes in Urinary Albumin-to-Creatinine Ratio and Risk of Abnormal Ankle-Brachial Index in a Community-Based Chinese Population

Ankle Brachial Index and Subsequent Cardiovascular Disease Risk in Patients With Chronic Kidney Disease

Peripheral arterial disease and cardiovascular risk. The importance of Doppler in multi-pathological population

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