BACKGROUND: Screening for peripheral artery disease (PAD) may reduce morbidity and mortality. PURPOSE: To review the evidence on the ability of the ankle-brachial index (ABI) to predict cardiovascular disease (CVD) morbidity and mortality independent of Framingham Risk Score (FRS) factors in asymptomatic adults and on the benefits and harms of treating screen-detected adults with PAD. DATA SOURCES: MEDLINE and the Cochrane Central Register of Controlled Trials (1996 to September 2012), clinical trial registries, reference lists, and experts. STUDY SELECTION: English-language, population-based prognostic studies evaluating the ABI in addition to the FRS and treatment trials or studies of treatment harms in screen-detected adults with PAD. DATA EXTRACTION: Dual quality assessment and abstraction of relevant study details. DATA SYNTHESIS: One large meta-analysis (n = 43 919) showed that the ABI could reclassify 10-year risk for coronary artery disease (CAD), but it did not report measures of appropriate reclassification (the net reclassification improvement [NRI]). Four heterogeneous risk prediction studies showed that the magnitude of the NRI was probably small when the ABI was added to the FRS to predict CAD or CVD events. Of 2 treatment trials meeting inclusion criteria, 1 large trial (n = 3350) showed that low-dose aspirin did not prevent CVD events in persons with a screen-detected low ABI but may have increased the risk for major bleeding events. LIMITATIONS: Most prognostic studies did not allow for calculation of a bias-corrected NRI. Evidence on treatment benefits and harms was limited to aspirin and was scant. CONCLUSION: Adding the ABI to the FRS probably has limited value for predicting CAD or CVD. Treatment benefits for asymptomatic individuals with screen-detected PAD are not established. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
BACKGROUND: Screening for peripheral artery disease (PAD) may reduce morbidity and mortality. PURPOSE: To review the evidence on the ability of the ankle-brachial index (ABI) to predict cardiovascular disease (CVD) morbidity and mortality independent of Framingham Risk Score (FRS) factors in asymptomatic adults and on the benefits and harms of treating screen-detected adults with PAD. DATA SOURCES: MEDLINE and the Cochrane Central Register of Controlled Trials (1996 to September 2012), clinical trial registries, reference lists, and experts. STUDY SELECTION: English-language, population-based prognostic studies evaluating the ABI in addition to the FRS and treatment trials or studies of treatment harms in screen-detected adults with PAD. DATA EXTRACTION: Dual quality assessment and abstraction of relevant study details. DATA SYNTHESIS: One large meta-analysis (n = 43 919) showed that the ABI could reclassify 10-year risk for coronary artery disease (CAD), but it did not report measures of appropriate reclassification (the net reclassification improvement [NRI]). Four heterogeneous risk prediction studies showed that the magnitude of the NRI was probably small when the ABI was added to the FRS to predict CAD or CVD events. Of 2 treatment trials meeting inclusion criteria, 1 large trial (n = 3350) showed that low-dose aspirin did not prevent CVD events in persons with a screen-detected low ABI but may have increased the risk for major bleeding events. LIMITATIONS: Most prognostic studies did not allow for calculation of a bias-corrected NRI. Evidence on treatment benefits and harms was limited to aspirin and was scant. CONCLUSION: Adding the ABI to the FRS probably has limited value for predicting CAD or CVD. Treatment benefits for asymptomatic individuals with screen-detected PAD are not established. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
Authors: Gerald S Bloomfield; Allison K DeLong; Constantine O Akwanalo; Joseph W Hogan; E Jane Carter; Daniel F Aswa; Cynthia Binanay; Myra Koech; Sylvester Kimaiyo; Eric J Velazquez Journal: Glob Heart Date: 2016-03
Authors: Marie D Gerhard-Herman; Heather L Gornik; Coletta Barrett; Neal R Barshes; Matthew A Corriere; Douglas E Drachman; Lee A Fleisher; Francis Gerry R Fowkes; Naomi M Hamburg; Scott Kinlay; Robert Lookstein; Sanjay Misra; Leila Mureebe; Jeffrey W Olin; Rajan A G Patel; Judith G Regensteiner; Andres Schanzer; Mehdi H Shishehbor; Kerry J Stewart; Diane Treat-Jacobson; M Eileen Walsh Journal: Circulation Date: 2016-11-13 Impact factor: 29.690
Authors: Cintia B Ueta; Katia S Gomes; Márcio A Ribeiro; Daria Mochly-Rosen; Julio C B Ferreira Journal: Pharmacol Res Date: 2016-11-19 Impact factor: 7.658
Authors: Joel L Ramirez; Kimberly A Spaulding; Greg J Zahner; Sukaynah A Khetani; Melinda S Schaller; Warren J Gasper; Nancy K Hills; S Marlene Grenon Journal: J Surg Res Date: 2018-11-01 Impact factor: 2.192