Jarosław Królczyk1,2, Karolina Piotrowicz1,2, Anna Skalska1,2, Małgorzata Mossakowska3, Tomasz Grodzicki1,2, Jerzy Gąsowski4,5. 1. Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 2 Jakubowskiego St., 31-501, Krakow, Poland. 2. University Hospital in Krakow, Krakow, Poland. 3. Study On Ageing and Longevity, International Institute of Molecular and Cell Biology, Warsaw, Poland. 4. Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 2 Jakubowskiego St., 31-501, Krakow, Poland. jerzy.gasowski@uj.edu.pl. 5. University Hospital in Krakow, Krakow, Poland. jerzy.gasowski@uj.edu.pl.
Abstract
BACKGROUND: Ankle-brachial index (ABI) is a screening tool for peripheral arterial disease (PAD). However, persons with normal ABI may still exhibit abnormalities in the physical examination of arterial system (PHEA). OBJECTIVE: In older persons from the PolSenior study, we aimed to assess the risk of total mortality associated with abnormalities in PHEA in the context of dichotomised ABI. METHODS: We used data from the PolSenior survey and matched them with mortality information from the Polish Census Bureau. We obtained sociodemographic, medical history, and lifestyle data. The PHEA by a geriatrician included carotid, femoral, popliteal, posterior tibial and the dorsalis pedis arterial pulses, and auscultation of aorta, carotid, femoral, and renal arteries. Ankle-brachial index was tibial to brachial SBP ratio. We plotted the stratified Kaplan-Meier curves and used Cox's regression to assess the unadjusted and adjusted influence of PHEA result on time to death. RESULTS: The mean (standard deviation, SD) age of 852 persons (46.7% women) was 74.7 (10.6) years. In the ABI < 0.9 group, the PHEA was not associated with mortality. However, in the ABI ≥ 0.9 group, both in unadjusted and adjusted (RHR; 95% CI: 1.08; 1.02-1.16, p = 0.01) Cox regression, PHEA greater by 1 score was associated with mortality. Presence of 4 or more PHEA abnormalities was raising the risk in the ABI ≥ 0.9 group to the level associated with ABI < 0.9. CONCLUSIONS: In the older persons with normal ABI, the greater number of abnormalities during physical examination of arteries may be indicative of higher risk of death.
BACKGROUND: Ankle-brachial index (ABI) is a screening tool for peripheral arterial disease (PAD). However, persons with normal ABI may still exhibit abnormalities in the physical examination of arterial system (PHEA). OBJECTIVE: In older persons from the PolSenior study, we aimed to assess the risk of total mortality associated with abnormalities in PHEA in the context of dichotomised ABI. METHODS: We used data from the PolSenior survey and matched them with mortality information from the Polish Census Bureau. We obtained sociodemographic, medical history, and lifestyle data. The PHEA by a geriatrician included carotid, femoral, popliteal, posterior tibial and the dorsalis pedis arterial pulses, and auscultation of aorta, carotid, femoral, and renal arteries. Ankle-brachial index was tibial to brachial SBP ratio. We plotted the stratified Kaplan-Meier curves and used Cox's regression to assess the unadjusted and adjusted influence of PHEA result on time to death. RESULTS: The mean (standard deviation, SD) age of 852 persons (46.7% women) was 74.7 (10.6) years. In the ABI < 0.9 group, the PHEA was not associated with mortality. However, in the ABI ≥ 0.9 group, both in unadjusted and adjusted (RHR; 95% CI: 1.08; 1.02-1.16, p = 0.01) Cox regression, PHEA greater by 1 score was associated with mortality. Presence of 4 or more PHEA abnormalities was raising the risk in the ABI ≥ 0.9 group to the level associated with ABI < 0.9. CONCLUSIONS: In the older persons with normal ABI, the greater number of abnormalities during physical examination of arteries may be indicative of higher risk of death.
Authors: Piotr Bledowski; Malgorzata Mossakowska; Jerzy Chudek; Tomasz Grodzicki; Andrzej Milewicz; Aleksandra Szybalska; Katarzyna Wieczorowska-Tobis; Andrzej Wiecek; Adam Bartoszek; Andrzej Dabrowski; Tomasz Zdrojewski Journal: Exp Gerontol Date: 2011-09-28 Impact factor: 4.032
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: R Ramos; M Quesada; P Solanas; I Subirana; J Sala; J Vila; R Masiá; C Cerezo; R Elosua; M Grau; F Cordón; D Juvinyà; M Fitó; M Isabel Covas; A Clarà; M Angel Muñoz; J Marrugat Journal: Eur J Vasc Endovasc Surg Date: 2009-06-10 Impact factor: 7.069
Authors: Jarosław Królczyk; Karolina Piotrowicz; Jerzy Chudek; Monika Puzianowska-Kuźnicka; Małgorzata Mossakowska; Aleksandra Szybalska; Tomasz Grodzicki; Anna Skalska; Jerzy Gąsowski Journal: Aging Clin Exp Res Date: 2018-12-17 Impact factor: 3.636