Comparison of different ankle-brachial indices in the prediction of overall and cardiovascular mortality.

Abstract:

BACKGROUND AND AIMS:Low ankle-brachial index (ABI) calculated using systolic blood pressure (SBP) is associated with poor prognosis. However, there is no study assessing ABI calculated using mean artery pressure (MAP) and diastolic blood pressure (DBP) in predicting mortality. METHODS:Two cohort populations were enrolled. The first population comprised 379 patients (106 patients with angiography-proved peripheral artery disease (PAD) and 273 relative normal patients) to evaluate the best cutoff values of ABImbp and ABIdbp for prediction of PAD. The second population included 941 patients undergoing echocardiographic examinations to assess the ability of different ABIs in predicting mortality. ABIs were measured using an ABI-form device. RESULTS:The best cutoff values of ABImbp and ABIdbp for prediction of PAD were 0.92 and 0.88. In our second population, median follow-up to mortality was 93 months. There were 87 cardiovascular and 228 overall deaths. Multivariable analysis showed ABIsbp, ABImap, ABIdbp, ABIsbp <0.9, and ABImap <0.92 could predict overall and cardiovascular mortality (all p < 0.001). ABIdbp <0.88 could only predict CV mortality (p = 0.033). In a direct comparison of 6 multivariable models, the basic model consisting of significant variables in the univariable analysis plus ABImap <0.92 had the highest predictive value for overall and cardiovascular mortality (all p < 0.001). CONCLUSIONS:In a direct comparison of 6 multivariable models, the basic model + ABImap < 0.92 was the best model in predicting overall and cardiovascular mortality. Hence, calculation of ABI using MAP except SBP might provide extra benefit in survival prediction.

journal_name

Atherosclerosis

journal_title

Atherosclerosis

authors

Hsu PC,Lee WH,Chen YC,Lee MK,Tsai WC,Chu CY,Lee CS,Yen HW,Lin TH,Voon WC,Lai WT,Sheu SH,Su HM

doi

10.1016/j.atherosclerosis.2020.04.005

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

57-63

eissn

0021-9150

issn

1879-1484

pii

S0021-9150(20)30200-8

journal_volume

304

pub_type

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