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JURNAL TENTANG ABI

1. Ankle brachial index screening in asymptomatic older adults Original Research Article

American Heart Journal, Volume 161, Issue 5, May 2011, Pages 979-985

Ruth E. Taylor-Piliae, Joan M. Fair, Ann N. Varady, Mark A. Hlatky, Linda C. Norton, CarlosIribarren, Alan S. Go, Stephen P. Fortmann

Background

Screening for peripheral arterial disease (PAD) by measuring ankle brachial index (ABI) in

asymptomatic older adults is currently recommended to improve cardiovascular disease risk

assessment and establish early treatment, but it is not clear if the strategy is useful in all

populations. We examined the prevalence and independent predictors of an abnormal ABI (


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We assessed whether ethnicity was an independent predictor of ABI and ankle systolic blood

pressure (SBP) in linear regression models that adjusted for conventional and novel

cardiovascular risk factors. To minimize effects of atherosclerosis on ABI, we studied adults aged

60 years, and also repeated our analyses in a subset aged 50 years that did not have risk

factors for PAD.

Results3348 participants aged 60 years were included in the study. Mean ABI was 1.11 in non-Hispanic

Blacks (NHB) and 1.13 in non-Hispanic Whites (NHW) (P< 0.0001). In multivariable linear

regression analysis that adjusted for age, gender, ethnicity, smoking, height, diabetes, brachial

SBP, dyslipidemia, diabetes, renal function, concurrent cardiovascular disease, and plasma levels

of homocysteine, fibrinogen and C-reactive protein, NHB had lower ABI than NHW

( = 0.03 0.004, P< 0.00001). Although, NHBs had higher ankle SBP than NHWs (by

5.4 mm Hg), NHBs had a lower mean ankle SBP ( = 3.663 mm Hg 0.500, P< 0.0001) after

adjusting for clinical covariates, including brachial SBP, in multivariable analysis.

Conclusion

Ethnic differences in ABI are present in middle-aged adults at low risk for peripheral

atherosclerosis.

3. Combination of ankle brachial index and diabetes mellitus to predict cardiovascular events

and mortality after an acute coronary syndromeOriginal Research Article

International Journal of Cardiology, Volume 151, Issue 1, 18 August 2011, Pages 84-88

Juan Quiles, Pedro Morillas, Vicente Bertomeu, Pilar Mazon, Alberto Cordero, Federico Soria,

Lorenzo Facila, Jose Ramon Gonzalez-Juanatey, On behalf of The Prevalence of Peripheral

Arterial Disease in Patients with Acute Coronary Syndrome (PAMISCA) Investigators

Objective

Diabetes mellitus and low ankle brachial index (ABI) are both conditions associated with an

increased cardiovascular risk. In the setting of an acute coronary syndrome (ACS), diabetes is

associated with increased mortality, but little is known regarding a low ABI. The aim of the study

was to evaluate the prevalence of diabetes and low ABI in patients after an ACS and their

prognostic value.

Methods

1156 patients 40 years admitted with an ACS were screened with ABI previous to hospital

discharge to investigate the presence of peripheral arterial disease (PAD) (ABI value 0.9). 1054

were finally followed for one year. Patients were stratified according to diabetes and PAD status.

The primary endpoint of the study was all-cause mortality.

Results

The prevalence of diabetes was 36% and PAD was 39.9%. After a median follow up of 382 days,

59 patients died (5.6%), the majority from a cardiovascular event. In both diabetic and nondiabetic

patients, the presence of PAD was significantly associated with an increased incidence of the

primary event. After adjustment for several prognostic variables, patients with diabetes and PAD

had an increased risk of mortality (HR 4.05 (95% CI 1.86-8.83)). PAD and diabetic patients had an

intermediate and similar incidence of cardiovascular events.

Conclusions

Our results show that the presence of an ABI 0.9 predicts cardiovascular risk to the same extent

as diabetes, and the combination of diabetes and PAD is a powerful tool after an ACS to predictthe occurrence of an adverse event.
http://www.sciencedirect.com/science/article/pii/S0167527310003475http://www.sciencedirect.com/science/article/pii/S0167527310003475http://www.sciencedirect.com/science/article/pii/S0167527310003475http://www.sciencedirect.com/science/article/pii/S0167527310003475http://www.sciencedirect.com/science/article/pii/S0167527310003475http://www.sciencedirect.com/science/article/pii/S0167527310003475


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