High ankle brachial index predicts high risk of cardiovascular events amongst people with peripheral artery disease

Golledge, Jonathan, Moxon, Joseph V., Rowbotham, Sophie, Pinchbeck, Jenna, Quigley, Frank, and Jenkins, Jason (2020) High ankle brachial index predicts high risk of cardiovascular events amongst people with peripheral artery disease. PLoS ONE, 15 (11). e0242228.

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Abstract

Ankle-brachial pressure index (ABPI) is commonly measured in people referred to vascular specialists. This study aimed to assess the association of high ABPI (≥ 1.4) with cardiovascular events in people with peripheral artery disease (PAD). 1533 participants with PAD diagnosed by a vascular specialist were prospectively recruited from four out-patient clinics in Australia. ABPI was measured at recruitment and the occurrence of myocardial infarction (MI), stroke or cardiovascular death (major cardiovascular events; MACE) and any amputation were recorded over a median (inter-quartile range) follow-up of 3.3 (1.0-7.1) years. The association of high, compared to normal, low (0.5-0.9) or very low (<0.5), ABPI with clinical events was estimated using Cox proportional hazard analyses, adjusting for traditional risk factors and reported as hazard ratio with 95% confidence intervals. 596 (38.9%), 676 (44.1%), 157 (10.2%) and 104 (6.8%) participants had normal, low, very low and high ABPI, respectively. Participants with high ABPI had increased risk of MACE, MI and death by comparison to those with either normal ABPI [1.69 (1.07, 2.65), 1.93 (1.07, 3.46) and 1.67 (1.09, 2.56)] or either low or very low ABPI [1.51 (1.02, 2.23), 1.92 (1.16, 3.19) and 1.47 (1.02, 2.14)] after adjusting for other risk factors. Findings were similar in a sensitivity analysis excluding people with ABPI only measured in one leg (n = 120). Participants with high ABPI also had an increased risk of MACE and MI compared to those with very low ABPI alone. High ABPI is a strong indicator of excess risk of cardiovascular events amongst people with PAD.

Item ID: 67086
Item Type: Article (Research - C1)
ISSN: 1932-6203
Keywords: ankle brachial pressure index; ABPI; peripheral artery disease; PAD; cardiovascular; cardiovascular events
Copyright Information: Copyright: © 2020 Golledge et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funders: National Health and Medical Research Council (NHMRC), James Cook University (JCU), Queensland Government (QG)
Projects and Grants: NHMRC Practitioner Fellowship (1117061), NHMRC 1063476, NHMRC 1000967, QG Senior Clinical Research Fellowship, QG Advance Queensland Fellowship
Date Deposited: 09 Mar 2021 03:49
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320199 Cardiovascular medicine and haematology not elsewhere classified @ 100%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100%
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