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Predictive Value of the Ankle-Brachial Index for All-Cause and Cardio-Cerebrovascular Mortality

Chang Xu1,2, Qi Tian1,2, Hao Yu3

  • 1Department of Neurology, Geriatric Hospital of Nanjing Medical University, Jiangsu Province Official Hospital, Nanjing, China.

Angiology
|September 2, 2022
PubMed

Insights

The ankle-brachial index (ABI) indicates that an ABI of 1.11 is linked to the lowest risk of death from any cause. Lower ABI values are independently associated with increased mortality risk.

Area of Science:

  • Vascular Medicine
  • Epidemiology
  • Biostatistics

Background:

  • The ankle-brachial index (ABI) is a key indicator of peripheral artery disease.
  • Elevated ABI values may also be associated with increased cardiovascular risk.
  • Understanding the optimal ABI range for mortality risk is crucial for clinical practice.

Purpose of the Study:

  • To investigate the relationship between ABI levels and all-cause, cardiovascular, and cancer mortality.
  • To identify the specific ABI value associated with the lowest risk of all-cause mortality.
  • To evaluate the independent association of ABI with mortality risk after adjusting for confounders.

Main Methods:

  • Utilized data from the National Health and Nutrition Examination Survey (1999-2004).
  • Included 7087 participants with an average follow-up of 12.2 years.
  • Employed Cox regression models and Kaplan-Meier analysis to assess mortality risk across ABI quartiles and continuous scales.

Main Results:

  • The lowest ABI quartile (<1.06) was linked to the highest risk of all-cause, cardiovascular, and cancer mortality.
  • An ABI between 1.06 and 1.12 showed the lowest risk of all-cause mortality (HR 0.88).
  • The relationship between ABI and mortality was nonlinear, with an inflection point at 1.11.

Conclusions:

  • The ABI level associated with the lowest all-cause mortality risk is 1.11.
  • ABIs below 1.11 are independently associated with an increased risk of all-cause mortality.
  • These findings highlight the importance of considering both low and potentially high ABI values in mortality risk assessment.

Keywords:
all-cause mortalityankle-brachial indexarterial calcificationcardio-cerebrovascular mortalityperipheral arterial disease

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