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Ankle brachial pressure index but not brachial-ankle pulse wave velocity is a strong predictor of systemic atherosclerotic morbidity and mortality in patients on maintenance hemodialysis.
Atherosclerosis. 2011 Dec; 219(2):643-7.A

Abstract

BACKGROUND

Ankle brachial pressure index (ABPI) and pulse wave velocity (PWV) have been widely recognized as a marker of systemic atherosclerosis. We examined whether ABPI and brachial-ankle PWV (baPWV) predict individual cardiovascular events in patients on maintenance hemodialysis (HD).

METHODS

We prospectively followed-up 445 HD patients undergoing both ABPI and baPWV measurements for up to 5 years. They were divided into 2 groups [group with ABPI > 0.9 to ≤ 1.3 (n = 328) and group with ABPI ≤ 0.9 or >1.3 (n = 117)] and were also divided into tertiles according to the baPWV level (T1: <1850 cm/s; T2: 1850-2310 cm/s and T3: ≥ 2310 cm/s).

RESULTS

During the follow-up period (mean 43 ± 17 months), 206 cardiovascular events [cardiac event: 125 (28.1%), cerebrovascular events: 39 (8.8%), and peripheral arterial events: 42 (9.4%)] occurred, and 36 (8.1%) and 42 (9.4%) patients experienced cardiovascular and non-cardiovascular deaths, respectively. Cox multivariable analysis showed that presence of ABPI ≤ 0.9 or >1.3 was a significant predictor of cardiac events [hazard ratio (HR) 1.78, 95% confidential interval (CI) 1.27-2.49, p = 0.0008], cerebrovascular event (HR 1.95, 95%CI 1.13-3.36, p = 0.017), peripheral arterial event (HR 3.64, 95%CI 2.10-6.29, p < 0.0001), composite endpoint of cardiovascular events (HR 2.22, 95%CI 1.64-2.99, p < 0.0001), cardiovascular mortality (HR 2.42, 95%CI 1.44-4.06, p = 0.0008) and all-cause mortality (HR 1.52, 95%CI 1.03-2.25, p = 0.037). However, baPWV did not predict cardiovascular events on multivariate analysis.

CONCLUSION

ABPI but not baPWV is useful for risk stratification of systemic atherosclerotic morbidity and mortality in HD patients. Furthermore, ABPI could predict not only individual peripheral arterial events but also cardiac and cerebrovascular events.

Authors+Show Affiliations

Department of Cardiology, Nagoya Kyoritsu Hospital, Nagoya, Japan.No affiliation info availableNo 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

22018643

Citation

Tanaka, Miho, et al. "Ankle Brachial Pressure Index but Not Brachial-ankle Pulse Wave Velocity Is a Strong Predictor of Systemic Atherosclerotic Morbidity and Mortality in Patients On Maintenance Hemodialysis." Atherosclerosis, vol. 219, no. 2, 2011, pp. 643-7.
Tanaka M, Ishii H, Aoyama T, et al. Ankle brachial pressure index but not brachial-ankle pulse wave velocity is a strong predictor of systemic atherosclerotic morbidity and mortality in patients on maintenance hemodialysis. Atherosclerosis. 2011;219(2):643-7.
Tanaka, M., Ishii, H., Aoyama, T., Takahashi, H., Toriyama, T., Kasuga, H., Takeshita, K., Yoshikawa, D., Amano, T., & Murohara, T. (2011). Ankle brachial pressure index but not brachial-ankle pulse wave velocity is a strong predictor of systemic atherosclerotic morbidity and mortality in patients on maintenance hemodialysis. Atherosclerosis, 219(2), 643-7. https://doi.org/10.1016/j.atherosclerosis.2011.09.037
Tanaka M, et al. Ankle Brachial Pressure Index but Not Brachial-ankle Pulse Wave Velocity Is a Strong Predictor of Systemic Atherosclerotic Morbidity and Mortality in Patients On Maintenance Hemodialysis. Atherosclerosis. 2011;219(2):643-7. PubMed PMID: 22018643.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ankle brachial pressure index but not brachial-ankle pulse wave velocity is a strong predictor of systemic atherosclerotic morbidity and mortality in patients on maintenance hemodialysis. AU - Tanaka,Miho, AU - Ishii,Hideki, AU - Aoyama,Toru, AU - Takahashi,Hiroshi, AU - Toriyama,Takanobu, AU - Kasuga,Hirotake, AU - Takeshita,Kyosuke, AU - Yoshikawa,Daiji, AU - Amano,Tetsuya, AU - Murohara,Toyoaki, Y1 - 2011/10/01/ PY - 2011/07/04/received PY - 2011/09/17/revised PY - 2011/09/19/accepted PY - 2011/10/25/entrez PY - 2011/10/25/pubmed PY - 2012/4/6/medline SP - 643 EP - 7 JF - Atherosclerosis JO - Atherosclerosis VL - 219 IS - 2 N2 - BACKGROUND: Ankle brachial pressure index (ABPI) and pulse wave velocity (PWV) have been widely recognized as a marker of systemic atherosclerosis. We examined whether ABPI and brachial-ankle PWV (baPWV) predict individual cardiovascular events in patients on maintenance hemodialysis (HD). METHODS: We prospectively followed-up 445 HD patients undergoing both ABPI and baPWV measurements for up to 5 years. They were divided into 2 groups [group with ABPI > 0.9 to ≤ 1.3 (n = 328) and group with ABPI ≤ 0.9 or >1.3 (n = 117)] and were also divided into tertiles according to the baPWV level (T1: <1850 cm/s; T2: 1850-2310 cm/s and T3: ≥ 2310 cm/s). RESULTS: During the follow-up period (mean 43 ± 17 months), 206 cardiovascular events [cardiac event: 125 (28.1%), cerebrovascular events: 39 (8.8%), and peripheral arterial events: 42 (9.4%)] occurred, and 36 (8.1%) and 42 (9.4%) patients experienced cardiovascular and non-cardiovascular deaths, respectively. Cox multivariable analysis showed that presence of ABPI ≤ 0.9 or >1.3 was a significant predictor of cardiac events [hazard ratio (HR) 1.78, 95% confidential interval (CI) 1.27-2.49, p = 0.0008], cerebrovascular event (HR 1.95, 95%CI 1.13-3.36, p = 0.017), peripheral arterial event (HR 3.64, 95%CI 2.10-6.29, p < 0.0001), composite endpoint of cardiovascular events (HR 2.22, 95%CI 1.64-2.99, p < 0.0001), cardiovascular mortality (HR 2.42, 95%CI 1.44-4.06, p = 0.0008) and all-cause mortality (HR 1.52, 95%CI 1.03-2.25, p = 0.037). However, baPWV did not predict cardiovascular events on multivariate analysis. CONCLUSION: ABPI but not baPWV is useful for risk stratification of systemic atherosclerotic morbidity and mortality in HD patients. Furthermore, ABPI could predict not only individual peripheral arterial events but also cardiac and cerebrovascular events. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/22018643/Ankle_brachial_pressure_index_but_not_brachial_ankle_pulse_wave_velocity_is_a_strong_predictor_of_systemic_atherosclerotic_morbidity_and_mortality_in_patients_on_maintenance_hemodialysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(11)00943-9 DB - PRIME DP - Unbound Medicine ER -