Pathological ankle-brachial index is equivalent of advanced age in acute coronary syndromes.

Abstract:

BACKGROUND:Age is one the factors associated with poor prognosis in acute coronary syndromes (ACS) and elderly patients are a high-risk collective with few parameters for mid-term cardiovascular stratification. We aimed to assess the predictive value of ankle-brachial index (ABI) in patients (> 75 years) for 1-year mortality after an ACS. MATERIALS AND METHODS:Prospective, observational and multicentre study of ACS patients in whom ABI was assessed during hospitalization. RESULTS:A total of 1·054 patients were included, mean age 66·6 (11·7) years from whom 26·6% were > 75 years. Elderly patients showed more history of cardiovascular disease and higher prevalence of all risk factors, except current smoking. Angiography and revascularization were performed less frequently in the elderly. Patients > 75 years showed higher presence of three vessel coronary disease and received fewer guideline-recommended treatments. Patients who died through the follow-up, mean time 387·9 ± 7·2 days, had lower ABI (0·73 ± 0·24 vs. 0·92 ± 0·22; P < 0·01), also in the elderly patients (0·73 ± 0·24 vs. 0·86 ± 0·23; P < 0·01). Cox regression analysis identified age > 75 years (HR: 2·30; IC 95% 1·26-4·18; P < 0·01) and ABI < 0·90 (HR: 3·58; IC 95% 1·80-7·15; P < 0·01) as risk factors for to 1-year mortality. Mortality was similar in elderly patients with ABI > 0·90 and young patients with ABI < 0·90; the worst prognosis was observed in elderly patients with ABI < 0·90 (HR: 10·01; 95% CI 3·74-27·15). CONCLUSIONS:Elderly patients represent a relevant collective of patients with ACS and are treated less optimally. ABI predicts 1-year mortality after an ACS in elderly patients.

journal_name

Eur J Clin Invest

authors

Cordero A,Morillas P,Bertomeu-González V,Quiles J,Soria F,Guindo J,Mazón P,Anguita M,Rodríguez-Padial L,González-Juanatey JR,Bertomeu-Martínez V,en nombre de los investigadores del estudio PAMISCA.

doi

10.1111/j.1365-2362.2011.02533.x

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

1268-74

issue

12

eissn

0014-2972

issn

1365-2362

journal_volume

41

pub_type

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