Author(s): Feringa HH, Bax JJ, van Waning VH, Boersma E, Elhendy A, et al.
Background: Peripheral arterial disease is associated with a high incidence of cardiovascular mortality. Peripheral arterial disease can be detected by using the ankle-brachial index (ABI). This study assessed the prognostic value of the postexercise ABI in addition to the resting ABI on long-term mortality in patients with suspected peripheral arterial disease.
Methods: In this prospective cohort study of 3209 patients (mean +/- SD age, 63 +/- 12 years; 71.1% male), resting and postexercise ABI values were measured and a reduction of postexercise ABI over baseline resting readings was calculated. The mean follow-up was 8 years (interquartile range, 4-11 years).
Results: During follow-up, 1321 patients (41.2%) died. After adjusting for clinical risk factors, lower resting ABI values (hazard ratio per 0.10 lower ABI, 1.08; 95% confidence interval [CI], 1.06-1.10), lower postexercise ABI values (hazard ratio per 0.10 lower ABI, 1.09; 95% CI, 1.08-1.11), and higher reductions of ABI values over baseline readings (hazard ratio per 10% lower ABI, 1.12; 95% CI, 1.09-1.14) were significantly associated with a higher incidence of mortality. In patients with a normal resting ABI (n = 789), a reduction of the postexercise ABI by 6% to 24%, 25% to 55%, and greater than 55% was associated with a 1.6-fold (95% CI, 1.2-2.2), 3.5-fold (95% CI, 2.4-5.0), and 4.8-fold (95% CI, 2.5-9.1) increased risk of mortality, respectively.
Conclusions: Resting and postexercise ABI values are strong and independent predictors of mortality. A reduction of postexercise ABI over baseline readings can identify additional patients (who have normal ABI values at rest) at increased risk of subsequent mortality.
Referred From: https://www.ncbi.nlm.nih.gov/pubmed/16534039
Author(s): Criqui MH, Aboyans V
Author(s): Criqui MH, Langer RD, Fronek A, Feigelson HS, Klauber MR, et al.
Author(s): Grenon SM, Vittinghoff E, Owens CD, Conte MS, Whooley M, et al.
Author(s): McDermott MM, Liu K, Greenland P, Guralnik JM, Criqui MH, et al.
Author(s): Newman AB, Haggerty CL, Kritchevsky SB, Nevitt MC, Simonsick EM
Author(s): de Liefde II, Hoeks SE, van Gestel YR, Klein J, Bax JJ, et al.
Author(s): Lee JY, Lee SW, Lee WS, Han S, Park YK, et al.
Author(s): Del Brutto OH, Sedler MJ, Mera RM, Lama J, Gruen JA, et al.
Author(s): Gronewold J, Hermann DM, Lehmann N, Kröger K, Lauterbach K, et al.
Author(s): Garg PK, Tian L, Criqui MH, Liu K, Ferrucci L, et al.
Author(s): Gardner AW, Montgomery PS, Parker DE
Author(s): Bartelink ML, Stoffers HE, Biesheuvel CJ, Hoes AW
Author(s): Fokkenrood HJ, Bendermacher BL, Lauret GJ, Willigendael EM, Prins MH, et al.
Author(s): Kruidenier LM, Nicolaï SP, Rouwet EV, Peters RJ, Prins MH, et al.
Author(s): Vemulapalli S, Dolor RJ, Hasselblad V, Schmit K, Banks A, et al.
Author(s): Kruidenier LM, Nicolaï SP, Hendriks EJ, Bollen EC, Prins MH, et al.
Author(s): Bendermacher BL, Willigendael EM, Nicolaï SP, Kruidenier LM, Welten RJ, et al.
Author(s): Mika P, Spodaryk K, Cencora A, Unnithan VB, Mika A
Author(s): Bulmer AC, Coombes JS