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Prognostic Value of Abnormal Ankle-Brachial Index in Patients With Coronary Artery Disease: A Meta-Analysis

Longguang Liu1, Hongxiao Sun1, Fengze Nie1

  • 1Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China.

Angiology
|March 14, 2020
PubMed

Insights

An abnormal ankle-brachial index (ABI) in coronary artery disease (CAD) patients predicts major adverse cardiovascular events and all-cause mortality. This risk is primarily driven by a low ABI, not a high ABI.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Health
  • Diagnostic Biomarkers

Background:

  • The prognostic significance of the ankle-brachial index (ABI) in patients with coronary artery disease (CAD) is not well-established.
  • Peripheral artery disease, indicated by abnormal ABI, often coexists with CAD.

Purpose of the Study:

  • To meta-analyze the association between an abnormal ankle-brachial index (ABI) and adverse outcomes in patients with coronary artery disease (CAD).
  • To determine if ABI predicts major adverse cardiovascular events (MACE) and all-cause mortality in CAD patients.

Main Methods:

  • Systematic search of PubMed, Embase, CNKI, VIP, and Wanfang databases up to September 10, 2019.
  • Inclusion of observational studies assessing the link between baseline ABI and MACE or all-cause mortality in CAD patients.
  • Meta-analysis of risk ratios (RR) with 95% confidence intervals (CIs) for abnormal versus normal ABI.

Main Results:

  • Nine studies involving 9384 CAD patients were analyzed.
  • Abnormal ABI was independently associated with increased risk of MACE (RR: 2.46) and all-cause mortality (RR: 1.74).
  • Subgroup analysis indicated a higher MACE risk associated with low ABI (RR: 2.34), suggesting low ABI is the primary driver.

Conclusions:

  • Abnormal ABI is a significant independent predictor of MACE and all-cause mortality in patients with CAD.
  • The prognostic value of an abnormal ABI in CAD is predominantly attributed to a low ABI, rather than a high ABI.
  • Routine ABI assessment may aid in risk stratification for patients with coronary artery disease.

Keywords:
all-cause mortalityankle–brachial indexcoronary artery diseasemajor adverse cardiovascular eventsmeta-analysis

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