Abstract 13494: Ankle Brachial Index as a Predictor of the Extent of Coronary Atherosclerosis and Cardiovascular Events in Elderly Patients With Coronary Artery Disease
Introduction: Low ankle brachial index (ABI) is a marker of generalized atherosclerosis in the elderly.
Objectives: This study aimed to examine the relation, in elderly individuals with known coronary artery disease (CAD) without any symptoms of peripheral arterial disease, between ABI and the extent of coronary atherosclerosis, morbidity and short-term mortality.
Methods: Prospective cohort study; were included in the cohort a total of 100 consecutive patients aged 65 years or older (range 65 to 93) who had full clinical evaluation and underwent ABI and coronary angiography and who had at least one vessel with significant obstruction (>70%); subjects were followed up for 28.93 ± 6.62 months.
Results: Vascular risk factors such as smoking, hypertension, diabetes and metabolic syndrome were not related to ABI in the multiple regression analysis. Lower ABI was independently related to the extent of CAD as measured by number of coronary vessels involved in the cineangio (analysis of variance, p = 0,002). In the follow-up study lower ABI was an univariate predictor of major events (all-cause death, nonfatal myocardial infarction, unstable angina, and revascularization procedures). The ROC curve analysis showed that ABI ≤ 0.82 was the best cut-off (AUC = 0.66 ± 0.05; 95% CI 0.56 to 0.75; p = 0.005). In logistic regression analysis low ABI was an independent predictor for major events (OR 2.93; 95% CI 1.19 to 7.20; p = 0.01).
Conclusions: In elderly patients with known CAD confirmed by angio low ABI was independently associated with a high risk of all-cause mortality and major cardiovascular events in this prospective study. ABI seems to be a tool for predicting serious morbidity and mortality in the elderly with coronary disease, even if they don't have peripheral arterial disease symptoms at the time of their CAD identification.Figure: The ROC curve of ABI in relation to major cardiovascular events during follow up.
- © 2010 by American Heart Association, Inc.