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Prognostic significance of declining ankle-brachial index values in patients with suspected or known peripheral arterial disease.
Eur J Vasc Endovasc Surg. 2007 Aug; 34(2):206-13.EJ

Abstract

BACKGROUND

Peripheral arterial disease (PAD) is a risk factor for cardiovascular events. This study assessed the prognostic significance of repeated ankle-brachial index (ABI) measurements at rest and after exercise in patients with PAD receiving conservative treatment.

METHODS

In a cohort study of 606 patients (mean age 62+/-12 years, 68% male), ABI at rest and after exercise was measured at baseline and after 1 year. Patients with reductions in ABI were divided into three equally-sized groups (minor, intermediate and major reductions) and were compared to patients without reductions. During a mean follow-up of 5+/-3 years, all-cause mortality, cardiac events, stroke and progression to kidney failure were noted.

RESULTS

Death was recorded in 83 patients (14%) of which 49% were due to cardiac causes. Non-fatal myocardial infarction occurred in 38 patients (6%), stroke in 46 (8%) and progression to kidney failure in 35 (6%). By multivariate analysis, patients with major declines in resting (>20%) and post-exercise (>30%) ABI were at increased risk of all-cause mortality (HR: 3.3, 95% CI: 1.5-7.2, HR: 3.0, 95% CI: 1.4-6.4, respectively), cardiac events (HR: 3.1, 95% CI: 1.3-7.2, HR: 2.4, 95% CI: 1.1-5.6, respectively), stroke (HR: 4.2, 95% CI: 1.6-10.4, HR: 3.9, 95% CI: 1.4-10.2, respectively) and kidney failure (HR: 2.7, 95% CI: 1.1-7.5, HR: 6.9, 95% CI: 1.5-31.5, respectively), compared to patients with no declines in ABI.

CONCLUSIONS

This study shows that major 1-year declines in resting and post-exercise ABI are associated with all-cause mortality, cardiac events, stroke and kidney failure in patients with PAD.

Authors+Show Affiliations

Departments of Cardiology, Erasmus MC Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17481930

Citation

Feringa, H H H., et al. "Prognostic Significance of Declining Ankle-brachial Index Values in Patients With Suspected or Known Peripheral Arterial Disease." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 34, no. 2, 2007, pp. 206-13.
Feringa HH, Karagiannis SE, Schouten O, et al. Prognostic significance of declining ankle-brachial index values in patients with suspected or known peripheral arterial disease. Eur J Vasc Endovasc Surg. 2007;34(2):206-13.
Feringa, H. H., Karagiannis, S. E., Schouten, O., Vidakovic, R., van Waning, V. H., Boersma, E., Welten, G., Bax, J. J., & Poldermans, D. (2007). Prognostic significance of declining ankle-brachial index values in patients with suspected or known peripheral arterial disease. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 34(2), 206-13.
Feringa HH, et al. Prognostic Significance of Declining Ankle-brachial Index Values in Patients With Suspected or Known Peripheral Arterial Disease. Eur J Vasc Endovasc Surg. 2007;34(2):206-13. PubMed PMID: 17481930.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic significance of declining ankle-brachial index values in patients with suspected or known peripheral arterial disease. AU - Feringa,H H H, AU - Karagiannis,S E, AU - Schouten,O, AU - Vidakovic,R, AU - van Waning,V H, AU - Boersma,E, AU - Welten,G, AU - Bax,J J, AU - Poldermans,D, Y1 - 2007/05/04/ PY - 2006/11/09/received PY - 2007/02/21/accepted PY - 2007/5/8/pubmed PY - 2007/8/31/medline PY - 2007/5/8/entrez SP - 206 EP - 13 JF - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery JO - Eur J Vasc Endovasc Surg VL - 34 IS - 2 N2 - BACKGROUND: Peripheral arterial disease (PAD) is a risk factor for cardiovascular events. This study assessed the prognostic significance of repeated ankle-brachial index (ABI) measurements at rest and after exercise in patients with PAD receiving conservative treatment. METHODS: In a cohort study of 606 patients (mean age 62+/-12 years, 68% male), ABI at rest and after exercise was measured at baseline and after 1 year. Patients with reductions in ABI were divided into three equally-sized groups (minor, intermediate and major reductions) and were compared to patients without reductions. During a mean follow-up of 5+/-3 years, all-cause mortality, cardiac events, stroke and progression to kidney failure were noted. RESULTS: Death was recorded in 83 patients (14%) of which 49% were due to cardiac causes. Non-fatal myocardial infarction occurred in 38 patients (6%), stroke in 46 (8%) and progression to kidney failure in 35 (6%). By multivariate analysis, patients with major declines in resting (>20%) and post-exercise (>30%) ABI were at increased risk of all-cause mortality (HR: 3.3, 95% CI: 1.5-7.2, HR: 3.0, 95% CI: 1.4-6.4, respectively), cardiac events (HR: 3.1, 95% CI: 1.3-7.2, HR: 2.4, 95% CI: 1.1-5.6, respectively), stroke (HR: 4.2, 95% CI: 1.6-10.4, HR: 3.9, 95% CI: 1.4-10.2, respectively) and kidney failure (HR: 2.7, 95% CI: 1.1-7.5, HR: 6.9, 95% CI: 1.5-31.5, respectively), compared to patients with no declines in ABI. CONCLUSIONS: This study shows that major 1-year declines in resting and post-exercise ABI are associated with all-cause mortality, cardiac events, stroke and kidney failure in patients with PAD. SN - 1078-5884 UR - https://www.unboundmedicine.com/medline/citation/17481930/Prognostic_significance_of_declining_ankle_brachial_index_values_in_patients_with_suspected_or_known_peripheral_arterial_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-5884(07)00185-2 DB - PRIME DP - Unbound Medicine ER -