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(Circulation. 2006;113:329.)
© 2006 American Heart Association, Inc.
Issue Highlights
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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MORTALITY AND CARDIOVASCULAR RISK ACROSS THE ANKLE-ARM INDEX SPECTRUM: RESULTS FROM THE CARDIOVASCULAR HEALTH STUDY, by O’Hare et al. |
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The ankle arm index (AAI; ratio of ankle and arm systolic blood pressures) has been used as an indicator of subclinical and clinical peripheral vascular disease, and values below 0.9 and above 1.4 have been reported to indicate an adverse vascular prognosis. In this issue of Circulation, O’Hare and colleagues evaluated the mortality and cardiovascular risks associated with a broad range of AAI (categories defined in 0.1 unit increments from 0.6 to 1.4) in a large elderly community-based sample. Compared to the referent group with an AAI between 1.10 and 1.20, values below 1.0 and above 1.4 were associated with higher all-cause and cardiovascular mortality. Specifically, an AAI in the range 0.9 to 1.0 (often regarded as normal) was associated with a 40% higher mortality risk compared to the referent group, whereas a value above 1.40 was associated with a 57% greater mortality hazard. The authors noted effect modification by age, with stronger associations of high and low AAI with mortality risk in people below age 75 years. Overall, these observational data emphasize the nonlinear relations of AAI and mortality risk and raise the possibility that the mortality risk associated with a low AAI may extend to values above the traditional cut point of 0.9 (ie, to the range 0.9 to 1.0). See p 388.
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IMPACT OF PROSTHESIS-PATIENT MISMATCH ON LONG-TERM SURVIVAL IN PATIENTS WITH SMALL ST JUDE MEDICAL MECHANICAL PROSTHESES IN THE AORTIC POSITION, by Mohty-Echahidi et al. |
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The issue of prosthesis-patient mismatch continues to be an area of active clinical investigation. The article by Mohty-Echahidi et al focuses on long-term survival in a defined population of patients receiving an aortic
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