Abstract 12663: Ankle-brachial Index For Prognosis of Cardiovascular Disease in Patients With Mild Renal Insufficiency
Background: Low ankle-brachial index (ABI) is a known predictor for future cardiovascular events and mortality in patients with advanced stage chronic kidney disease (CKD) or undergoing hemodialysis. While most prior studies defined CKD as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, recent reports have demonstrated that cardiovascular risk may increase even in earlier stages of renal insufficiency. We hypothesized that low ABI may predict future cardiovascular morbidity and mortality in patients with mild impairment of renal function.
Methods: The IMPACT-ABI study was a retrospective, single-center, cohort study that enrolled and obtained ABI measurements for 3131 patients hospitalized for cardiovascular disease between January 2005 and December 2012. From this cohort, we identified 1511 patients with mild renal insufficiency (eGFR = 60-89 ml/min/1.73 m2), and stratified them into two groups: ABI ≤ 0.9 (low ABI group; 9.3%) and ABI > 0.9 (90.6%). The primary outcome measured was the cumulative incidence of major adverse cardiovascular events (MACE: cardiovascular death, myocardial infarction, and stroke).
Results: Over a mean follow-up of 5.1 years, 101 MACE occurred. The incidence of MACE was significantly higher in patients with low ABI than in those with ABI > 0.9 (29.7% vs. 14.3%, log rank P < 0.001). In multivariate Cox proportional hazard analysis adjusted for traditional cardiovascular risk factors, low ABI was an independent predictor of MACE (hazard ratio: 1.79; 95% confidence interval: 1.03-3.08; P = 0.036).
Conclusions: Low ABI was an independent predictor for MACE in patients with mild renal insufficiency.
Author Disclosures: H. Nishimura: None. T. Miura: None. M. Minamisawa: None. Y. Ueki: None. N. Abe: None. N. Hashizume: None. T. Mochidome: None. M. Harada: None. K. Shimizu: None. W. Shoin: None. K. Yoshie: None. Y. Oguchi: None. S. Ebisawa: None. H. Motoki: None. A. Izawa: None. J. Koyama: None. U. Ikeda: None.
- © 2016 by American Heart Association, Inc.