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The predictive value of the borderline ankle-brachial index for long-term clinical outcomes: An observational cohort

Shingo Tanaka1, Hidehiro Kaneko1, Hiroto Kano1

  • 1Department of Cardiovascular Medicine, The Cardiovascular Institute, 3-2-19, Nishiazabu, Minato-ku, Tokyo 106-0031, Japan.

Atherosclerosis
|May 17, 2016
PubMed

Insights

A borderline ankle-brachial index (ABI) is linked to a higher risk of death and cardiovascular events in patients with existing health issues. Further research is needed in broader populations.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Health
  • Clinical Outcomes Research

Background:

  • Low ankle-brachial index (ABI) is a known predictor of mortality and cardiovascular events.
  • The clinical significance of borderline ABI values, often overlooked, requires further investigation.

Purpose of the Study:

  • To evaluate the predictive value of a borderline ankle-brachial index (ABI) for clinical outcomes.
  • To determine if borderline ABI is an independent risk factor for mortality and cardiovascular events.

Main Methods:

  • A cohort study utilizing the Shinken Database (2004-2012) included 4756 subjects with ABI between 0.91-1.39 and no history of peripheral artery disease.
  • Subjects were categorized into borderline ABI (0.91-1.00) and normal ABI (1.01-1.39) groups.
  • Adjusted Cox regression models were used to analyze the association between borderline ABI and clinical outcomes.

Main Results:

  • The borderline ABI group (n=324) exhibited more comorbidities and poorer health markers compared to the normal ABI group (n=4432).
  • Subjects with borderline ABI had significantly higher rates of all-cause death (9.3%) and cardiovascular death (4.6%) compared to those with normal ABI (2.0% and 0.8%, respectively).
  • Borderline ABI was independently associated with increased all-cause mortality (HR 2.27) and cardiovascular mortality (HR 3.47).

Conclusions:

  • A borderline ankle-brachial index (ABI) is an independent predictor of adverse clinical outcomes, including mortality, in a relatively high-risk population.
  • These findings highlight the importance of considering borderline ABI values in risk assessment.
  • Validation in larger, diverse populations, including low-risk individuals, is recommended.
Abstract

Keywords:
Ankle-brachial indexBorderlinePeripheral arterial diseasePrognosis

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