In:
Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 5, No. 6 ( 2016-06-13)
Abstract:
The clinical implications of ankle‐brachial index ( ABI ) cutpoints are not well defined in patients with chronic kidney disease ( CKD ) despite increased prevalence of high ABI attributed to arterial stiffness. We examined the relationship of ABI with cardiovascular disease ( CVD ) and all‐cause mortality among CKD patients. Methods and Results Three thousand six hundred twenty‐seven participants without clinical peripheral artery disease ( PAD ) at baseline from the Chronic Renal Insufficiency Cohort Study were included. ABI was obtained per standard protocol and CVD events were confirmed by medical record adjudication. A U‐shaped association of ABI with PAD , myocardial infarction ( MI ), composite CVD , and all‐cause mortality was observed. Individuals with an ABI between 1.0 and 〈 1.4 had the lowest risk of outcomes. Compared to participants with an ABI between 1.0 and 〈 1.4, multiple‐adjusted hazard ratios (95% confidence intervals) for those with an ABI of 〈 0.9, 0.9 to 〈 1.0, and ≥1.4 were 5.78 (3.57, 9.35), 2.76 (1.56, 4.88), and 4.85 (2.05, 11.50) for PAD ; 1.67 (1.23, 2.29), 1.85 (1.33, 2.57), and 2.08 (1.10, 3.93) for MI ; 1.51 (1.27, 1.79), 1.39 (1.15, 1.68), and 1.23 (0.82, 1.84) for composite CVD ; and 1.55 (1.28, 1.89), 1.36 (1.10, 1.69), and 1.00 (0.62, 1.62) for all‐cause mortality, respectively. Conclusions This study indicates that ABI 〈 1.0 was related to risk of PAD , MI , composite CVD , and all‐cause mortality whereas ABI ≥1.4 was related to clinical PAD . These findings suggest that ABI cutpoints of 〈 1.0 or ≥1.4 for diagnosing PAD and ABI 〈 1.0 for CVD risk stratification should be further evaluated among CKD patients.
Type of Medium:
Online Resource
ISSN:
2047-9980
DOI:
10.1161/JAHA.116.003339
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2016
detail.hit.zdb_id:
2653953-6
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