The Ankle-Brachial Index is Associated With Cardiovascular Complications After Noncardiac Surgery

Carmo, Gabriel Assis Lopes do; Calderaro, Daniela; Gualandro, Danielle Menosi; Pastana, Adriana F.; Yu, Pai Ching; Marques, Ana Paula; Caramelli, Bruno

doi:10.1177/0003319715589684

Cited by 14 publications

(14 citation statements)

References 39 publications

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“…Two other studies evaluated ABI in patients undergoing noncardiac and nonvascular surgeries and obtained ORs of 10.2 and 7.0 for the occurrence of major cardiovascular events, including isolated increase of troponin. 97 , 98 …”

Section: Additional Preoperative Evaluationmentioning

confidence: 99%

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

Gualandro¹,

Yu²,

Caramelli³

et al. 2017

Arquivos Brasileiros De Cardiologia

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Section: Additional Preoperative Evaluationmentioning

confidence: 99%

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

Gualandro¹,

Yu²,

Caramelli³

et al. 2017

Arquivos Brasileiros De Cardiologia

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“…4 They suggest that measuring PWV could have been useful in our study. 3 We agree that the relationship between AS (assessed by PWV) and postoperative CV complications should be investigated. However, in our study, we used the ABI as a marker of lower extremity peripheral arterial disease (PAD) and not as a marker of AS.…”

mentioning

confidence: 67%

The Ankle-Brachial Index Is Associated With Cardiovascular Complications After Noncardiac Surgery

Carmo

Caramelli

2016

Angiology

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We thank Unlu et al 1 and Altun and Cintosun 2 for their interest in our study entitled ''The Ankle-Brachial Index Is Associated With Cardiovascular Complications After Noncardiac Surgery.'' 3 Altun and Cintosun 2 argue that pulse wave velocity (PWV) and ankle-brachial index (ABI) are markers of cardiovascular (CV) disease and that PWV is considered the gold standard for the measurement of arterial stiffness (AS). 4 They suggest that measuring PWV could have been useful in our study. 3 We agree that the relationship between AS (assessed by PWV) and postoperative CV complications should be investigated. However, in our study, we used the ABI as a marker of lower extremity peripheral arterial disease (PAD) and not as a marker of AS. Although PAD and AS may coexist, they are distinct and may not be present simultaneously (eg, a patient with an ABI > 1.4 may have AS but not always occlusive disease).Several studies have assessed the relationship of troponin elevation and CV complications after surgery. The Vascular Events in Noncardiac Surgery Patients Cohort Evaluation (VISION) trial and other studies, including 2 meta-analyses, have shown that isolated troponin elevation after surgery is associated with a worse prognosis in short-term and longterm follow-up. [5][6][7][8][9] The higher the troponin value, the worse the prognosis.In our study, preoperative serum creatinine (2.1 + 2.4 mg/dL vs 1.0 + 0.4 mg/dL, P ¼ .001), abnormal ABI (47.4% vs 20.0%, P ¼ .018), duration of anesthesia (444 + 184 minutes vs 372, + 176 minutes, P ¼ .041), and hemodynamic instability (46.0% vs 14.1%, P ¼ .001) were all associated with elevated levels of troponin. After logistic regression, an abnormal ABI (odds ratio [OR]: 13.4, 95% confidence interval [

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“…The ABPI has many uses besides establishing the diagnosis of peripheral arterial disease. [18][19][20][21][22][23] Although ABPI alone may identify CEF lesions with sensitivity and specificity of up to 100%, 5,6,15 it cannot determine the location of EF lesions. Color Doppler ultrasound proved effective in determining not only the presence or absence of disease but also the location.…”

Section: Discussionmentioning

confidence: 99%

Color Doppler Ultrasound Imaging in the Assessment of Iliac Endofibrosis

et al. 2016

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Endofibrosis (EF) of the iliac arteries is a flow-limiting condition typically seen in highly trained endurance athletes. Thirty-seven athletes (74 limbs) were referred to our department with suspected EF. All patients had a pre- and postexercise color Doppler ultrasound (CDU) of the iliac arteries. Doppler waveform and peak systolic velocity (PSV) and end-diastolic velocity (EDV) were assessed pre- and postexercise. Endofibrosis was diagnosed with CDU in 24 athletes (29 limbs). Arterial wall and course abnormalities were detected at rest in 20 (67%) symptomatic limbs of athletes with and 4 (22%) symptomatic limbs of athletes without EF. Postexercise abnormal waveforms of the stenotic/damped type were seen in the iliac arteries in all 29 limbs of athletes diagnosed with EF. These waveform changes were accompanied by high PSV (>350 cm/s) and EDV (>150 cm/s), with (n = 10; 34%) or without (n = 19; 66%) the evidence of reduced arterial lumen caliber. Color Doppler ultrasound can be used to detect EF.

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The Ankle-Brachial Index is Associated With Cardiovascular Complications After Noncardiac Surgery

Abstract: In patients submitted to noncardiac surgery, abnormal ABI is associated with a higher occurrence of a cardiovascular event.

Cited by 14 publications

References 39 publications

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

The Ankle-Brachial Index Is Associated With Cardiovascular Complications After Noncardiac Surgery

Color Doppler Ultrasound Imaging in the Assessment of Iliac Endofibrosis

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