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Pathological ankle-brachial index is equivalent of advanced age in acute coronary syndromes

Alberto Cordero1, Pedro Morillas, Vicente Bertomeu-González

  • 1Hospital Universitario de San Juan, Alicante, Spain. acorderofort@gmail.com

European Journal of Clinical Investigation
|April 27, 2011
PubMed

Insights

The ankle-brachial index (ABI) can predict 1-year mortality in elderly patients after acute coronary syndrome (ACS). Lower ABI values indicate a higher risk, especially in older individuals with ACS.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Geriatric Medicine

Background:

  • Age is a significant factor influencing prognosis in acute coronary syndromes (ACS).
  • Elderly patients (> 75 years) with ACS represent a high-risk group lacking adequate mid-term cardiovascular stratification tools.
  • This study investigates the predictive value of the ankle-brachial index (ABI) for mortality in this population.

Purpose of the Study:

  • To assess the ankle-brachial index (ABI) as a predictor of 1-year mortality in patients over 75 years old following an acute coronary syndrome (ACS).
  • To evaluate the prognostic value of ABI for cardiovascular stratification in elderly ACS patients.

Main Methods:

  • A prospective, observational, multicentre study involving 1,054 ACS patients.
  • Ankle-brachial index (ABI) was measured during hospitalization.
  • Follow-up was conducted to determine 1-year mortality rates.

Main Results:

  • Elderly patients (> 75 years) had a higher prevalence of cardiovascular disease and risk factors, received less frequent angiography and revascularization, and fewer guideline-recommended treatments.
  • Lower ABI values were significantly associated with increased 1-year mortality in both the overall ACS population and specifically in elderly patients.
  • Cox regression identified age > 75 years and ABI < 0.90 as independent risk factors for 1-year mortality. Elderly patients with ABI < 0.90 exhibited the worst prognosis (HR: 10.01).

Conclusions:

  • Elderly patients with ACS are a vulnerable group often undertreated.
  • The ankle-brachial index (ABI) is a valuable and independent predictor of 1-year mortality in elderly patients following an acute coronary syndrome.
  • ABI measurement offers a simple yet effective tool for cardiovascular risk stratification in older ACS patients.
Abstract

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