Abstract 16086: Association of the Ankle-Brachial Index With History of Myocardial Infarction and Stroke
Background: Ankle brachial index (ABI) testing is a simple, non-invasive method to diagnose peripheral artery disease (PAD) and is associated with all-cause mortality. The association of ABI levels and cardiovascular morbidity (myocardial infarction [MI] and stroke) is uncertain.
Methods and Results: Using data from the Life Line Screening program, over 3.6 million self-referred participants from 2003-2008 completed a medical and lifestyle questionnaire in the United States and had bilateral ABIs performed. Logistic regression was used to estimate the association between established ABI cutoff points (ABI<0.90 and ABI>1.40) and specific ABI levels with history of MI, stroke, and MI or stroke (MI/stroke). Models were adjusted for age, sex, race/ethnicity, smoking, diabetes, hypertension, hypercholesterolemia, physical activity, and family history of cardiovascular disease. Separate sex-specific models were performed. Overall, 165,754 (4.8%) had an ABI<0.90, and 14,299 (0.4%) had an ABI>1.40. An ABI<0.90 was associated with higher odds of MI (adjusted odds ratio [OR] 1.74, 95% CI 1.70-1.78, p<0.001), stroke (OR 1.79, 95% CI 1.74-1.84, p<0.001), and MI/stroke (OR 1.76, 95% CI 1.73-1.79, p<0.001). An ABI>1.40 was also associated with higher odds of MI (OR 1.25, 95% CI 1.16-1.345, p<0.001), stroke (OR 1.42, 95% CI 1.29-1.57, p<0.001), and MI/stroke (OR 1.31, 95% CI 1.23-1.40, p<0.001). The ORs for MI/stroke for different levels of ABI compared with a reference level of 1.11-1.20 formed a reverse J-shaped curve in both women and men. For levels of ABI below 1.10, the ORs for MI, stroke, and MI/stroke increased consistently with decreasing ABI.
Conclusions: In a large national screening database, there is a strong, consistent relationship between ABI levels and a history of prevalent MI, stroke, and MI/stroke.
- © 2013 by American Heart Association, Inc.