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Ankle-Brachial Index and cardiovascular events in atrial fibrillation. The ARAPACIS Study

Francesco Violi1, Giovanni Davì, Marco Proietti

  • 1Prof. Francesco Violi, I Clinica Medica, Sapienza-University of Rome, Viale del Policlinico 155, Rome, 00161, Italy, Tel.: +39 06 4461933, Fax: +39 06 49970103,

Thrombosis and Haemostasis
|January 8, 2016
PubMed

Insights

Low Ankle-Brachial Index (ABI) predicts vascular death and myocardial infarction (MI) in non-valvular atrial fibrillation (NVAF) patients. This finding aids cardiovascular risk assessment in this high-risk population.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Atherosclerosis Research

Background:

  • Atrial fibrillation (AF) patients face elevated risks of thrombotic and vascular events due to cardiac arrhythmia and systemic atherosclerosis.
  • The Ankle-Brachial Index (ABI) is a validated, non-invasive measure of systemic atherosclerosis and cardiovascular event prediction in the general population.
  • Limited data exist on the utility of ABI in predicting vascular events specifically within the non-valvular atrial fibrillation (NVAF) patient cohort.

Purpose of the Study:

  • To investigate the association between a low Ankle-Brachial Index (ABI ≤ 0.90) and the occurrence of vascular events in patients with non-valvular atrial fibrillation (NVAF).
  • To determine if low ABI is an independent predictor of vascular events, vascular death, and myocardial infarction (MI) in NVAF patients.

Main Methods:

  • The ARAPACIS study enrolled 2,027 out- or in-patients with NVAF across 136 Italian centers.
  • Patients were followed for a median of 34.7 months, with data collected on vascular events, vascular death, and myocardial infarction (MI).
  • Cox proportional hazard analysis was employed to assess the predictive value of ABI ≤ 0.90 for vascular events.

Main Results:

  • A total of 176 patients (8.7%) experienced a vascular event over 4,614 patient-years of observation.
  • Low ABI (≤ 0.90) was significantly more prevalent in patients who experienced vascular events (32.2% vs. 20.2%, p<0.05).
  • ABI ≤ 0.90 independently predicted vascular events (HR: 1.394), vascular death (HR: 2.047), and MI (HR: 2.709) in NVAF patients.

Conclusions:

  • A low Ankle-Brachial Index (ABI) is a valuable, independent predictor of myocardial infarction (MI) and vascular death in non-valvular atrial fibrillation (NVAF) patients.
  • Incorporating ABI measurement into routine assessments can enhance cardiovascular risk stratification for NVAF patients.
  • Low ABI did not show an association with stroke or transient ischemic attack in this NVAF cohort.

Keywords:
ABIARAPACISAtrial fibrillationmyocardial infarctionvascular events

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