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Association between the ankle-brachial index and future coronary calcium (the Rancho Bernardo study)

Matthew A Allison1, Gail A Laughlin, Elizabeth Barrett-Connor

  • 1The Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California, USA. mallison@ucsd.edu

The American Journal of Cardiology
|January 31, 2006
PubMed

Insights

The ankle-brachial index (ABI) predicts future coronary artery calcium (CAC) buildup in individuals without heart disease. Lower ABI values, particularly below 1.0, indicate a higher risk of developing significant CAC over time.

Area of Science:

  • Cardiovascular Medicine
  • Diagnostic Imaging
  • Biomarkers

Background:

  • The ankle-brachial index (ABI) is a common test for peripheral artery disease.
  • Coronary artery calcium (CAC) is a marker of subclinical atherosclerosis.
  • The relationship between ABI and CAC in individuals without clinical coronary heart disease (CHD) is not fully understood.

Purpose of the Study:

  • To investigate the association between ABI and the presence and extent of CAC.
  • To determine if ABI can predict future CAC in a cohort free of clinical CHD.

Main Methods:

  • A cohort of 279 community-based subjects underwent ABI measurements and electron beam computed tomography for CAC assessment.
  • ABI was measured 7 years prior to CAC assessment.
  • Multivariable analysis was used to assess the association between ABI and CAC, controlling for potential confounders.

Main Results:

  • A U-shaped relationship was observed between CAC and ABI categories, with the lowest CAC scores between 1.0 and 1.09.
  • Women with an ABI < 1.0 had a 2.7-fold higher risk of increased CAC (p=0.03).
  • Men with an ABI < 1.0 showed a similar, though not statistically significant, increase in risk (OR 2.1, p=0.1).

Conclusions:

  • ABI is significantly associated with the future presence and extent of CAC.
  • Lower ABI values may serve as an early indicator of subclinical atherosclerosis and future cardiovascular risk.
  • ABI has potential as a predictive biomarker for coronary artery calcification.

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