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Influence of an abnormal ankle-brachial index on ischemic and bleeding events in patients undergoing percutaneous

Hangyul Kim1, Seung Do Lee1, Hyo Jin Lee1

  • 1Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.

The Korean Journal of Internal Medicine
|April 20, 2023
PubMed

Insights

An abnormal ankle-brachial index (ABI) increases risks for bleeding and ischemic events after percutaneous coronary intervention (PCI). This finding aids in optimizing secondary prevention strategies for PCI patients.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Bleeding events post-percutaneous coronary intervention (PCI) significantly impact patient prognosis.
  • Limited data exists on how abnormal ankle-brachial index (ABI) affects both ischemic and bleeding risks in PCI patients.

Purpose of the Study:

  • To investigate the association between an abnormal ankle-brachial index (ABI) and adverse clinical outcomes, including ischemic and bleeding events, in patients undergoing PCI.

Main Methods:

  • A cohort of 4,747 patients undergoing PCI with available ABI data (≤ 0.9 or > 1.4) was analyzed.
  • The primary endpoint comprised a composite of all-cause death, myocardial infarction (MI), stroke, and major bleeding.
  • Outcomes were assessed over a median follow-up of 31 months.

Main Results:

  • An abnormal ABI was present in 12.9% of patients (610 individuals).
  • The 5-year cumulative incidence of the primary endpoint was significantly higher in the abnormal ABI group (36.0%) compared to the normal ABI group (14.5%).
  • Abnormal ABI independently predicted all-cause death (HR, 3.05), stroke (HR, 1.79), and major bleeding (HR, 1.61).

Conclusions:

  • An abnormal ankle-brachial index is identified as a significant risk factor for both ischemic and bleeding complications following PCI.
  • These findings can inform the development of tailored secondary prevention strategies for patients after PCI.
Abstract

Keywords:
Ankle-brachial indexBleeding eventIschemic eventPercutaneous coronary interventionPeripheral artery disease

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