AIMS: Peripheral arterial disease (PAD) is the well-known risk factor for cardiovascular events. Although low ankle-brachial index (ABI) is recognized as a risk factor in general population, low ABI without any symptoms of PAD has not been established as a prognostic marker in patients with acute myocardial infarction (AMI) yet. The purpose of this retrospective study was to examine whether asymptomatic low ABI was associated with long-term clinical outcomes in AMI patients without treatment history of PAD. METHODS: We included 850 AMI patients without a history of PAD and divided them into the preserved ABI (ABI ≥ 0.9) group (n=760) and the reduced ABI (ABI ＜0.9) group (n=90) on the basis of the ABI measurement during the hospitalization. The primary endpoint was the major adverse cardiovascular events (MACE) defined as the composite of all-cause death, non-fatal myocardial infarction, and hospitalization for heart failure. RESULTS: During the median follow-up duration of 497 days (Q1: 219 days to Q3: 929 days), a total of 152 MACE were observed. The Kaplan-Meier curves showed that MACE were more frequently observed in the reduced ABI group than in the preserved ABI group (p＜0.001). The multivariate COX hazard analysis revealed that reduced ABI was significantly associated with MACE (hazard ratio 2.046, 95% confidence interval 1.344-3.144, p=0.001) after controlling confounding factors. CONCLUSIONS: Reduced ABI was significantly associated with long-term adverse events in AMI patients without a history of PAD. Our results suggest the usefulness of ABI as a prognostic marker in AMI patients irrespective of symptomatic PAD.
AIMS: Peripheral arterial disease (PAD) is the well-known risk factor for cardiovascular events. Although low ankle-brachial index (ABI) is recognized as a risk factor in general population, low ABI without any symptoms of PAD has not been established as a prognostic marker in patients with acute myocardial infarction (AMI) yet. The purpose of this retrospective study was to examine whether asymptomatic low ABI was associated with long-term clinical outcomes in AMI patients without treatment history of PAD. METHODS: We included 850 AMI patients without a history of PAD and divided them into the preserved ABI (ABI ≥ 0.9) group (n=760) and the reduced ABI (ABI ＜0.9) group (n=90) on the basis of the ABI measurement during the hospitalization. The primary endpoint was the major adverse cardiovascular events (MACE) defined as the composite of all-cause death, non-fatal myocardial infarction, and hospitalization for heart failure. RESULTS: During the median follow-up duration of 497 days (Q1: 219 days to Q3: 929 days), a total of 152 MACE were observed. The Kaplan-Meier curves showed that MACE were more frequently observed in the reduced ABI group than in the preserved ABI group (p＜0.001). The multivariate COX hazard analysis revealed that reduced ABI was significantly associated with MACE (hazard ratio 2.046, 95% confidence interval 1.344-3.144, p=0.001) after controlling confounding factors. CONCLUSIONS: Reduced ABI was significantly associated with long-term adverse events in AMI patients without a history of PAD. Our results suggest the usefulness of ABI as a prognostic marker in AMI patients irrespective of symptomatic PAD.
Authors: Kristian Thygesen; Joseph S Alpert; Allan S Jaffe; Bernard R Chaitman; Jeroen J Bax; David A Morrow; Harvey D White Journal: J Am Coll Cardiol Date: 2018-08-25 Impact factor: 24.094
Authors: Victor Aboyans; Jean-Baptiste Ricco; Marie-Louise E L Bartelink; Martin Björck; Marianne Brodmann; Tina Cohnert; Jean-Philippe Collet; Martin Czerny; Marco De Carlo; Sebastian Debus; Christine Espinola-Klein; Thomas Kahan; Serge Kownator; Lucia Mazzolai; A Ross Naylor; Marco Roffi; Joachim Röther; Muriel Sprynger; Michal Tendera; Gunnar Tepe; Maarit Venermo; Charalambos Vlachopoulos; Ileana Desormais Journal: Eur Heart J Date: 2018-03-01 Impact factor: 29.983
Authors: Eugenia Nikolsky; Roxana Mehran; Gary S Mintz; George D Dangas; Alexandra J Lansky; Eve D Aymong; Manuela Negoita; Martin Fahy; Issam Moussa; Gary S Roubin; Jeffrey W Moses; Gregg W Stone; Martin B Leon Journal: J Endovasc Ther Date: 2004-02 Impact factor: 3.487