The prognosis of diabetic patients with high ankle-brachial index depends on the coexistence of occlusive peripheral artery disease

Aboyans, Victor; Lacroix, Philippe; Tran, Minhhoang; Salamagne, Claire; Galinat, S.; Archambeaud, F.; Criqui, Michael H.; Laskar, Marc

doi:10.1016/j.jvs.2010.10.054

Cited by 48 publications

(42 citation statements)

References 25 publications

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“…A vascular laboratory study from France in people with diabetes mellitus reported that increased risk of mortality for an ABI of ≥1.40 was restricted to people with underlying PAD. 157 In contrast, a report from the Mayo Clinic vascular laboratory showed an independent risk for a high ABI that was further increased in the presence of underlying PAD. 158 Further studies on this question are needed.…”

Section: -144mentioning

confidence: 93%

Epidemiology of Peripheral Artery Disease

Criqui

Aboyans

2015

Circulation Research

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New data on the epidemiology of peripheral artery disease (PAD) are available, and they should be integrated with previous data. We provide an updated, integrated overview of the epidemiology of PAD, a focused literature review was conducted on the epidemiology of PAD. The PAD results were grouped into symptoms, diagnosis, prevalence, and incidence both in the United States and globally, risk factors, progression, coprevalence with other atherosclerotic disease, and association with incident cardiovascular morbidity and mortality. The most common symptom of PAD is intermittent claudication, but noninvasive measures, such as the anklebrachial index, show that asymptomatic PAD is several times more common in the population than intermittent claudication. PAD prevalence and incidence are both sharply age-related, rising >10% among patients in their 60s and 70s. With aging of the global population, it seems likely that PAD will be increasingly common in the future. Prevalence seems to be higher among men than women for more severe or symptomatic disease. The major risk factors for PAD are similar to those for coronary and cerebrovascular disease, with some differences in the relative importance of factors. Smoking is a particularly strong risk factor for PAD, as is diabetes mellitus, and several newer risk markers have shown independent associations with PAD. PAD is strongly associated with concomitant coronary and cerebrovascular diseases. After adjustment for known cardiovascular disease risk factors, PAD is associated with an increased risk of incident coronary and cerebrovascular disease morbidity and mortality.

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Section: -144mentioning

confidence: 93%

Epidemiology of Peripheral Artery Disease

Criqui

Aboyans

2015

Circulation Research

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961

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“…6 One explanation for an increased risk associated with a high ABI is that a high ABI caused by calcified arteries is associated frequently with occlusive PAD. 131 Patients with established CVD who also have a low ABI are at higher risk compared with patients with CVD who have a normal ABI. [132][133][134] This is consistent with the observation that in patients with evidence of disease in Ͼ1 vascular bed, the 3-year vascular event rate is Ͼ60% higher than in those with disease in only 1 vascular territory.…”

Section: Abi and Risk Of Future Cardiovascular Eventsmentioning

confidence: 99%

Measurement and Interpretation of the Ankle-Brachial Index

Aboyans

Criqui²,

Ábrahám³

et al. 2012

Circulation

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T he ankle-brachial index (ABI) is the ratio of the systolic blood pressure (SBP) measured at the ankle to that measured at the brachial artery. Originally described by Winsor 1 in 1950, this index was initially proposed for the noninvasive diagnosis of lower-extremity peripheral artery disease (PAD). 2,3 Later, it was shown that the ABI is an indicator of atherosclerosis at other vascular sites and can serve as a prognostic marker for cardiovascular events and functional impairment, even in the absence of symptoms of PAD. 4 -6 Rationale for Standardization of the ABIThe current lack of standards for measurement and calculation of the ABI leads to discrepant results with significant impact from clinical, public health, and economic standpoints. Indeed, the estimated prevalence of PAD may vary substantially according to the mode of ABI calculation. [7][8][9] In a review of 100 randomly selected reports using the ABI, multiple variations in technique were identified, including the position of the patient during measurement, the sizes of the arm and leg cuffs, the location of the cuff on the extremity, the method of pulse detection over the brachial artery and at the ankles, whether the arm and ankle pressures were measured bilaterally, which ankle pulses were used, and whether a single or replicate measures were obtained. 10 There is controversy about what ABI threshold should be used to diagnose PAD. The ABI threshold most commonly used is Յ0.90 based on studies reporting Ͼ90% sensitivity and specificity to detect PAD compared with angiography. 2,3 These studies were limited in that they included mostly older white men with PAD or who were at high risk for PAD and compared them with a younger healthy group. A recent metaanalysis of 8 studies of diverse populations, including diabetic patients, confirmed a high specificity but lower sensitivity (at best Ͻ80%) than that reported in earlier studies. 11 Similar to other vascular markers such as carotid intimamedia thickness 12 or coronary artery calcium score, 13 standardization of the techniques used to measure the ABI and the calculation and interpretation of its values is necessary. Aims and ScopeThe goals for this document are to provide a comprehensive review of the relevant literature on the measurement of the The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on September 10, 2012. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional repri...

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“…In approximately half of these cases, occlusive artery disease due to atherosclerosis coexists [58]. Two studies support the hypothesis that in patients with very high ABI, only those with concomitant medial calcinosis and occlusive disease are at increased risk of death [59,60]. Hence, in case of an ABI >1.40, further tests (e.g.…”

Section: Ankle-brachial Index (Abi)mentioning

confidence: 85%

The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation

Vlachopoulos¹,

Xaplanteris²,

Aboyans³

et al. 2015

Atherosclerosis

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While risk scores are invaluable tools for adapted preventive strategies, a significant gap exists between predicted and actual event rates. Additional tools to further stratify the risk of patients at an individual level are biomarkers. A surrogate endpoint is a biomarker that is intended as a substitute for a clinical endpoint. In order to be considered as a surrogate endpoint of cardiovascular events, a biomarker should satisfy several criteria, such as proof of concept, prospective validation, incremental value, clinical utility, clinical outcomes, cost-effectiveness, ease of use, methodological consensus, and reference values. We scrutinized the role of peripheral (i.e. not related to coronary circulation) noninvasive vascular biomarkers for primary and secondary cardiovascular disease prevention. Most of the biomarkers examined fit within the concept of early vascular aging. Biomarkers that fulfill most of the criteria and, therefore, are close to being considered a clinical surrogate endpoint are carotid ultrasonography, ankle-brachial index and carotid-femoral pulse wave velocity; biomarkers that fulfill some, but not all of the criteria are brachial ankle pulse wave velocity, central haemodynamics/wave reflections and C-reactive protein; biomarkers that do no not at present fulfill essential criteria are flow-mediated dilation, endothelial peripheral arterial tonometry, oxidized LDL and dysfunctional HDL. Nevertheless, it is still unclear whether a specific vascular biomarker is overly superior. A prospective study in which all vascular biomarkers are measured is still lacking. In selected cases, the combined assessment of more than one biomarker may be required.

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The prognosis of diabetic patients with high ankle-brachial index depends on the coexistence of occlusive peripheral artery disease

Abstract: In diabetics with ABI >1.40, only those with concommittant occlusive PAD have poorer prognosis.

Cited by 48 publications

References 25 publications

Epidemiology of Peripheral Artery Disease

Epidemiology of Peripheral Artery Disease

Measurement and Interpretation of the Ankle-Brachial Index

The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation

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