Abstract 12551: Prevalence of Low Ankle-brachial Index in Patients With Atrial Fibrillation
Objectives: This study sought to explore the prevalence of Ankle/Brachial Index (ABI) ≤0.90 in patients with nonvalvular atrial fibrillation (AF) and its contribution to overall prevalence of cardiovascular disease, as assessed by CHA2DS2-VASc score.
Background: In AF patients, cardiovascular disease, including a history of peripheral artery disease (PAD), is a component of CHA2DS2-VASc score. ABI ≤0.90 is a marker of PAD and provides independent prediction of cardiovascular events. Prevalence of ABI ≤0.90 in large AF population is still unknown.
Methods: The Atrial fibrillation Registry for ABI Prevalence Assessment-Collaborative Italian Study (ARAPACIS) is a prospective multicenter study. ABI was measured in 2,027 consecutive AF patients referred to 136 centers of the Italian Society of Internal Medicine.
Results: 428 (21%) patients had ABI ≤ 0.90 and 1,381 had ABI 0.90-1.39 (69%); whilst 204 patients (10%) had ABI ≥1.40. Logistic regression analysis demonstrated that ABI ≤0.90 was significantly associated with smoking [OR, 2.01 (95% CI, 1.49-2.71)], diabetes [OR, 1.99 (1.55-2.55)], age 65-74 [OR, 2.08 (1.39-3.10)], age≥75 [OR, 3.00 (2.04-4.42)], and history of TIA/stroke [OR, 1.66 (1.21-2.28)]. A history of coronary and peripheral artery disease was detected in 17.3% of patients; but the inclusion of ABI≤0.90 in the definition of cardiovascular disease yielded a total prevalence of 33% and enhanced cardiovascular disease prevalence in each class of the CHA2DS2-VASc score.
Conclusions: One fifth of AF patients have an ABI ≤0.90 and are at potentially higher risk of cardiovascular events. ABI enhances vascular disease prevalence and could be included in the AF cardiovascular risk assessment.
- © 2013 by American Heart Association, Inc.