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The Ankle-Brachial Index is Associated With Cardiovascular Complications After Noncardiac Surgery

G A Carmo1, D Calderaro1, D M Gualandro1

  • 1Interdisciplinary Medicine in Cardiology Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, Brazil.

Angiology
|June 11, 2015
PubMed

Insights

An abnormal ankle-brachial index (ABI) indicates peripheral artery disease (PAD) and is linked to increased cardiovascular complications following noncardiac surgery. Early detection can improve patient outcomes.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Perioperative Medicine

Background:

  • The ankle-brachial index (ABI) is a non-invasive test assessing peripheral artery disease (PAD).
  • Cardiovascular complications are a significant concern in patients undergoing noncardiac surgery.

Purpose of the Study:

  • To investigate the association between abnormal ABI and the incidence of cardiovascular events after noncardiac surgery.
  • To identify the risk of perioperative cardiovascular complications in patients with PAD.

Main Methods:

  • Prospective evaluation of 124 patients undergoing noncardiac surgery.
  • ABI measurement pre-surgery; patients with ABI ≤ 0.9 formed the PAD group.
  • Follow-up to 30 days for cardiovascular events including death, ACS, ITE, HF, shock, arrhythmias, arrest, edema, stroke, and PAD symptoms.

Main Results:

  • Patients with abnormal ABI (PAD group) experienced a significantly higher event rate (57.9%) compared to controls (25.7%, P = .011).
  • Isolated troponin elevation (ITE) was the most frequent event (24.2%).
  • Logistic regression revealed an odds ratio of 7.4 for ITE in the PAD group (95% CI 2.2-25.0, P = .001).

Conclusions:

  • An abnormal ABI is a significant predictor of increased cardiovascular event occurrence in patients undergoing noncardiac surgery.
  • The findings highlight the importance of ABI screening in this patient population to identify individuals at higher risk.
Abstract

Keywords:
ankle-brachial indexatherosclerosiscardiovascular riskperioperative care

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