• Jong-Young Lee, Seung-Whan Lee, Woo Seok Lee, Seungbong Han, Yong Kyu Park, Chang Hee Kwon, Jeong Yoon Jang, Young-Rak Cho, Gyung-Min Park, Jung-Min Ahn, Won-Jang Kim, Duk-Woo Park, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, and Seung-Jung Park.
• Division of Cardiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea.
• JACC Cardiovasc Interv. 2013 Dec 1; 6 (12): 1303-13.

ObjectivesThis study sought to evaluate the association between newly revealed abnormal ankle-brachial index (ABI) and clinical outcomes in patients with significant coronary artery stenosis.BackgroundLittle is known about the prevalence and clinical implications of ABI in patients with no claudication or previous history of peripheral artery disease who undergo diagnostic coronary angiography.MethodsBetween January 1, 2006, and December 31, 2009, ABI was evaluated in 2,543 consecutive patients with no clinical history of claudication or peripheral artery disease who underwent diagnostic coronary angiography. Abnormal ABI was defined as ≤0.9 or ≥1.4. The primary endpoint was the composite of death, myocardial infarction, and stroke over 3 years.ResultsOf the 2,543 patients, 390 (15.3%) had abnormal ABI. Of the 2,424 patients with at least 1 significant stenosis (≥50%) in a major epicardial coronary artery, 385 (15.9%) had abnormal ABI, including 348 (14.4%) with ABI ≤0.9 and 37 (1.5%) with ABI ≥1.4. During a median follow-up of 986 days, the 3-year major adverse event rate was significantly higher in patients with abnormal than normal ABI (15.7% vs. 3.3%, p < 0.001). After multivariate analysis, abnormal ABI was identified as a predictor of primary endpoint (hazard ratio [HR]: 1.87; 95% confidence interval [CI]: 1.23 to 2.84; p = 0.004). After adjustment by propensity-score matching, abnormal ABI could predict adverse clinical events in patients with established coronary artery disease (HR: 2.40; 95% CI: 1.41 to 4.10; p = 0.001).ConclusionsThe prevalence of newly revealed abnormal, asymptomatic ABI among patients who have significant CAD on coronary angiography was 15.9%. The presence of abnormal ABI was associated with a higher incidence of adverse clinical outcomes over 3 years.Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

54 keywords...

hide…