Abstract 3318: Ankle Brachial Index (ABI) Is The Single Most Relevant Independent Prognostic Marker For Recurrent Vascular Events. 5 Years Of Follow Up Of The AIRVAG Cohort
Objectives. To assess the prognostic value of the number of vascular territories affected (nVT) and other markers of atherosclerotic burden in secondary prevention.
Patients and Methods. Prospective cohort of 269 patients with clinical atherosclerosis: coronary (CHD 52%), cerebrovascular (CVD 33%), or peripheral (PVD 15%). Evaluation of event-free survival by Cox multivariate regression (SPSS v.13).
Results. PVD was most often associated with clinical involvement of other territories (54% vs CHD 29%, CVD 19%, p<0.05). After a median follow-up of 54 months, 60 patients (22.3%) had a new vascular event. nVT was associated with a higher risk of recurrence (HR 1.9 95% CI 1.2–3.0; p = .006). However, once a VT is affected the presence of an additional VT conferred an additional risk only for PVD (HR 1.9 95% CI 1.2–3.0; p = ,006; CHD HR 0.75, 95% CI 0.5–1.3 p NS; CVD HR 1.1, 95% CI 0.7–1.9; p NS, Fig⇓). ABI was a better predictor of new events (ABI <0.9 HR 2.02 p=.008) than intima-media thickness (IMT>0.9 mm HR 1.1, NS) or CRP (CRP>3g/L HR 1.2 NS). HR for ABI remained essentially unchanged after adjustments for age, sex, classical risk factors, IMT and CRP (Table⇓).
Conclusions. ABI is a more powerful marker for recurrence of vascular events in secondary prevention than other accessible markers of atherosclerotic burden such as IMT or CRP. ABI may be a very useful tool for detecting patients of very high risk.