A Low Ankle Brachial Index is Associated with an Increased Risk of Cardiovascular Disease: The Hisayama Study

Kojima, Iwao; Ninomiya, Toshiharu; Hata, Jun; Fukuhara, Mikio; Hirakawa, Yoichiro; Mukai, Naoko; Yoshida, Daigo; Kitazono, Takanari; Kiyohara, Yutaka

doi:10.5551/jat.22608

Cited by 41 publications

(36 citation statements)

References 28 publications

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“…Earlier studies of diabetic patients, cardiovascular risk patients, and the general patient population showed that patients with borderline ABI had a poorer prognosis than those with normal ABI [7, 13, 14, 15]. Current study could confirm the same trend in hospitalized cardiology patients.…”

Section: Discussionsupporting

confidence: 55%

“…[5, 6] Moreover, a low ABI (≤0.9) is strongly associated with generalized atherosclerosis, cardiovascular mortality and all-cause death, regardless of the presence of symptoms. [7, 8] Recently, the American College of Cardiology and the American Heart Association (ACC/AHA) guidelines for the management of peripheral artery disease patients recommended that 0.91 ≤ ABI ≤ 0.99 be considered borderline, and that patients with borderline ABI should be considered a high risk group, similar to patients with an abnormal ABI (ABI ≤ 0.9). [9, 10] However, there were few data available on the long-term future cardiovascular events in patients with borderline ABI, especially among the hospitalized cardiology population, who are admitted to the hospital most frequently.…”

Section: Introductionmentioning

confidence: 99%

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Impressive predictive value of ankle-brachial index for very long-term outcomes in patients with cardiovascular disease: IMPACT-ABI study

et al. 2017

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BackgroundThe ankle—brachial index (ABI) is a marker of generalized atherosclerosis and is predictive of future cardiovascular events. However, few studies have assessed its relation to long-term future cardiovascular events, especially in patients with borderline ABI. We therefore evaluated the relationship between long-term future cardiovascular events and ABI.MethodsIn the IMPACT-ABI study, a single-center, retrospective cohort study, we enrolled 3131 consecutive patients (67 ± 13 years; 82% male) hospitalized for cardiovascular disease and measured ABI between January 2005 and December 2012. After excluding patients with an ABI > 1.4, the remaining 3056 patients were categorized as having low ABI (≤ 0.9), borderline ABI (0.91–0.99), or normal ABI (1.00–1.40). The primary endpoint was MACE (cardiovascular death, myocardial infarction [MI] and stroke). The secondary endpoints were cardiovascular death, MI, stroke, admission due to heart failure, and major bleeding.ResultsDuring a 4.8-year mean follow-up period, the incidences of MACE (low vs. borderline vs. normal: 32.9% vs. 25.0% vs. 14.6%, P<0.0001) and cardiovascular death (26.2% vs. 18.7% vs. 8.9%, P<0.0001) differed significantly across ABIs. The incidences of stroke (9.1% vs. 8.6% vs. 4.8%, P<0.0001) and heart failure (25.7% vs. 20.8% vs. 8.9%, P<0.0001) were significantly higher in the low and borderline ABI groups than in the normal ABI group. But the incidences of MI and major bleeding were similar in the borderline and normal ABI groups. The hazard ratios for MACE adjusted for traditional atherosclerosis risk factors were significantly higher in patients with low and borderline ABI than those with normal ABI (HR, 1.93; 95%CI: 1.44–2.59, P < 0.0001, HR, 1.54; 95% CI: 1.03–2.29, P = 0.035).ConclusionsThe incidence of long-term adverse events was markedly higher among patients with low or borderline ABI than among those with normal ABI. This suggests that more attention should be paid to patients with borderline ABIs, especially with regard to cardiovascular death, stroke, and heart failure.

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Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Impressive predictive value of ankle-brachial index for very long-term outcomes in patients with cardiovascular disease: IMPACT-ABI study

et al. 2017

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“…34,40 In a community-dwelling population aged >40 years living in Japan, a low prevalence of PAD (1.4%) has been reported. 74 …”

Section: Race and Ethnicitymentioning

confidence: 99%

Epidemiology of Peripheral Artery Disease

Criqui

Aboyans

2015

Circulation Research

1,278

969

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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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“…Studies have shown that low ABI (ABI < 0.9) was related to the severity and degree of coronary artery disease and related to increased risk in recurrent of major cardiovascular events [61]. The risk of cardiovascular events increased independently of conventional risk factors in people with ABI equal or less than 0.90 [62]. In addition, high ABI values (>1.40 or incompressible) were correlated with greater left ventricular mass measured by cardiac magnetic resonance [63].…”

Section: Measurement Of Limb Artery-ankle Brachial Index (Abi)mentioning

confidence: 99%

Early Detection System of Vascular Disease and Its Application Prospect

Liu

Wang

2016

BioMed Research International

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Markers of imaging, structure, and function reflecting vascular damage, integrating a long time accumulation effect of traditional and unrecognized cardiovascular risk factors, can be regarded as surrogate endpoints of target organ damage before the occurrence of clinical events. Prevention of cardiovascular disease requires risk stratification and treatment of traditional risk factors, such as smoking, hypertension, hyperlipidemia, and diabetes. However, traditional risk stratification is not sufficient to provide accurate assessment of future cardiovascular events. Therefore, vascular injury related parameters obtained by ultrasound or other noninvasive devices, as a surrogate parameter of subclinical cardiovascular disease, can improve cardiovascular risk assessment and optimize the preventive treatment strategy. Thus, we will summarize the research progress and clinical application of early assessment technology of vascular diseases in the present review.

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A Low Ankle Brachial Index is Associated with an Increased Risk of Cardiovascular Disease: The Hisayama Study

Cited by 41 publications

References 28 publications

Impressive predictive value of ankle-brachial index for very long-term outcomes in patients with cardiovascular disease: IMPACT-ABI study

Impressive predictive value of ankle-brachial index for very long-term outcomes in patients with cardiovascular disease: IMPACT-ABI study

Epidemiology of Peripheral Artery Disease

Early Detection System of Vascular Disease and Its Application Prospect

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