Seung Hwa Lee1, Seung-Hyuk Choi2, Eun Kyoung Kim1, Jeong Hoon Yang1, Young Bin Song1, Joo-Yong Hahn1, Jin-Ho Choi1, Hyeon-Cheol Gwon1, Sang Hoon Lee1, Duk-Kyung Kim1. 1. Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 2. Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: sh1214.choi@samsung.com.
Abstract
OBJECTIVE: To evaluate the association between borderline ankle-brachial index (ABI) and clinical outcome in patients who underwent percutaneous coronary intervention (PCI). METHODS: From August 2009 to August 2012, ABI was measured in 1291 patients who underwent PCI. Patients with borderline ABI were compared with those who had normal ABI. The primary outcome was major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of all-cause death, myocardial infarction, stroke, and repeat revascularization. RESULTS: Of the 1291 patients, 1154 (82%) had normal ABI and 89 (7%) had borderline ABI. The median overall follow-up duration was 19 (interquartile range 13-26) months. After adjustment with IPTW, the incidence of stroke (HR, 6.28; CI 95%, 1.95-20.19; P < 0.01) and MACCE (HR, 2.54; CI 95%, 1.40-4.62; P < 0.01) were higher in the borderline ABI group. In a propensity score-matched population, the incidence of stroke (HR, 4.68; CI 95%, 1.18-18.52; p = 0.03) and MACCE (HR, 2.12; CI 95%, 1.09-4.11; P = 0.03) were still significantly higher. CONCLUSION: The presence of borderline ABI was associated with worse clinical outcome and increased stroke rate compared with normal ABI during the short-term follow-up period in patients who underwent coronary intervention.
OBJECTIVE: To evaluate the association between borderline ankle-brachial index (ABI) and clinical outcome in patients who underwent percutaneous coronary intervention (PCI). METHODS: From August 2009 to August 2012, ABI was measured in 1291 patients who underwent PCI. Patients with borderline ABI were compared with those who had normal ABI. The primary outcome was major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of all-cause death, myocardial infarction, stroke, and repeat revascularization. RESULTS: Of the 1291 patients, 1154 (82%) had normal ABI and 89 (7%) had borderline ABI. The median overall follow-up duration was 19 (interquartile range 13-26) months. After adjustment with IPTW, the incidence of stroke (HR, 6.28; CI 95%, 1.95-20.19; P < 0.01) and MACCE (HR, 2.54; CI 95%, 1.40-4.62; P < 0.01) were higher in the borderline ABI group. In a propensity score-matched population, the incidence of stroke (HR, 4.68; CI 95%, 1.18-18.52; p = 0.03) and MACCE (HR, 2.12; CI 95%, 1.09-4.11; P = 0.03) were still significantly higher. CONCLUSION: The presence of borderline ABI was associated with worse clinical outcome and increased stroke rate compared with normal ABI during the short-term follow-up period in patients who underwent coronary intervention.