AIMS: Peripheral arterial occlusive disease is associated with a high risk of cardiovascular morbidity and mortality. We prospectively examined the association of the ankle-brachial index (ABI) and arterial plaques in carotid and femoral arteries with incident myocardial infarctions (MIs) and cardiovascular and total mortality in 1325 participants of the population-based MONICA Augsburg Survey 1989/90. METHODS AND RESULTS: At baseline, 6.1% of men and 2.6% of women had an ABI < or =0.9. At least one plaque in the carotid or femoral arteries was identified in 51.8% of men and 36.3% of women. During a 13-year follow-up, 58 persons (4.4%) suffered a MI before age 75 and 189 persons (14.3%) died, 86 (6.5%) of them from cardiovascular causes. Kaplan-Meier curves confirmed both measurements as strong predictors for all three endpoints (P<0.0001). Cox regression analysis revealed an increase of the risk for MI and cardiovascular and total mortality of 22 (P=0.012), 35, and 32% (P<0.00001), respectively, per 0.1 unit decrease in ABI. Correction for measurement error in ABI increased these estimates. The increase in risk for MI and cardiovascular and total mortality was 52, 70, and 45%, respectively, for each increase in the number of plaque-affected arteries (P<0.0001). CONCLUSION: Both ABI and number of plaque-affected arteries are strong predictors for incident MI and cardiovascular and total mortality.
AIMS: Peripheral arterial occlusive disease is associated with a high risk of cardiovascular morbidity and mortality. We prospectively examined the association of the ankle-brachial index (ABI) and arterial plaques in carotid and femoral arteries with incident myocardial infarctions (MIs) and cardiovascular and total mortality in 1325 participants of the population-based MONICA Augsburg Survey 1989/90. METHODS AND RESULTS: At baseline, 6.1% of men and 2.6% of women had an ABI < or =0.9. At least one plaque in the carotid or femoral arteries was identified in 51.8% of men and 36.3% of women. During a 13-year follow-up, 58 persons (4.4%) suffered a MI before age 75 and 189 persons (14.3%) died, 86 (6.5%) of them from cardiovascular causes. Kaplan-Meier curves confirmed both measurements as strong predictors for all three endpoints (P<0.0001). Cox regression analysis revealed an increase of the risk for MI and cardiovascular and total mortality of 22 (P=0.012), 35, and 32% (P<0.00001), respectively, per 0.1 unit decrease in ABI. Correction for measurement error in ABI increased these estimates. The increase in risk for MI and cardiovascular and total mortality was 52, 70, and 45%, respectively, for each increase in the number of plaque-affected arteries (P<0.0001). CONCLUSION: Both ABI and number of plaque-affected arteries are strong predictors for incident MI and cardiovascular and total mortality.
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Authors: Joanne M Murabito; Charles C White; Maryam Kavousi; Yan V Sun; Mary F Feitosa; Vijay Nambi; Claudia Lamina; Arne Schillert; Stefan Coassin; Joshua C Bis; Linda Broer; Dana C Crawford; Nora Franceschini; Ruth Frikke-Schmidt; Margot Haun; Suzanne Holewijn; Jennifer E Huffman; Shih-Jen Hwang; Stefan Kiechl; Barbara Kollerits; May E Montasser; Ilja M Nolte; Megan E Rudock; Andrea Senft; Alexander Teumer; Pim van der Harst; Veronique Vitart; Lindsay L Waite; Andrew R Wood; Christina L Wassel; Devin M Absher; Matthew A Allison; Najaf Amin; Alice Arnold; Folkert W Asselbergs; Yurii Aulchenko; Stefania Bandinelli; Maja Barbalic; Mladen Boban; Kristin Brown-Gentry; David J Couper; Michael H Criqui; Abbas Dehghan; Martin den Heijer; Benjamin Dieplinger; Jingzhong Ding; Marcus Dörr; Christine Espinola-Klein; Stephan B Felix; Luigi Ferrucci; Aaron R Folsom; Gustav Fraedrich; Quince Gibson; Robert Goodloe; Grgo Gunjaca; Meinhard Haltmayer; Gerardo Heiss; Albert Hofman; Arne Kieback; Lambertus A Kiemeney; Ivana Kolcic; Iftikhar J Kullo; Stephen B Kritchevsky; Karl J Lackner; Xiaohui Li; Wolfgang Lieb; Kurt Lohman; Christa Meisinger; David Melzer; Emile R Mohler; Ivana Mudnic; Thomas Mueller; Gerjan Navis; Friedrich Oberhollenzer; Jeffrey W Olin; Jeff O'Connell; Christopher J O'Donnell; Walter Palmas; Brenda W Penninx; Astrid Petersmann; Ozren Polasek; Bruce M Psaty; Barbara Rantner; Ken Rice; Fernando Rivadeneira; Jerome I Rotter; Adrie Seldenrijk; Marietta Stadler; Monika Summerer; Toshiko Tanaka; Anne Tybjaerg-Hansen; Andre G Uitterlinden; Wiek H van Gilst; Sita H Vermeulen; Sarah H Wild; Philipp S Wild; Johann Willeit; Tanja Zeller; Tatijana Zemunik; Lina Zgaga; Themistocles L Assimes; Stefan Blankenberg; Eric Boerwinkle; Harry Campbell; John P Cooke; Jacqueline de Graaf; David Herrington; Sharon L R Kardia; Braxton D Mitchell; Anna Murray; Thomas Münzel; Anne B Newman; Ben A Oostra; Igor Rudan; Alan R Shuldiner; Harold Snieder; Cornelia M van Duijn; Uwe Völker; Alan F Wright; H-Erich Wichmann; James F Wilson; Jacqueline C M Witteman; Yongmei Liu; Caroline Hayward; Ingrid B Borecki; Andreas Ziegler; Kari E North; L Adrienne Cupples; Florian Kronenberg Journal: Circ Cardiovasc Genet Date: 2011-12-23
Authors: F G R Fowkes; G D Murray; I Butcher; A R Folsom; A T Hirsch; D J Couper; G Debacker; M Kornitzer; A B Newman; K C Sutton-Tyrrell; M Cushman; A J Lee; J F Price; R B D'Agostino; J M Murabito; Pe Norman; K H Masaki; L M Bouter; R J Heine; C D A Stehouwer; M M McDermott; H E J H Stoffers; J A Knottnerus; M Ogren; B Hedblad; W Koenig; C Meisinger; J A Cauley; Oh Franco; M G M Hunink; A Hofman; J C Witteman; M H Criqui; R D Langer; W R Hiatt; R F Hamman Journal: Eur J Prev Cardiol Date: 2013-12-23 Impact factor: 7.804