Low, borderline and normal ankle-brachial index as a predictor of incidents outcomes in the Mediterranean based-population ARTPER cohort after 9 years follow-up
Por:
Alzamora, MT, Fores, R, Pera, G, Baena-Diez, JM, Valverde, M and Toran, P
Publicada:
23 ene 2019
Ahead of Print:
23 ene 2019
Categoría:
Multidisciplinary
Resumen:
Background
Guidelines recommended adopting the same cardiovascular risk modification strategies used for coronary disease in case of low Ankle-brachial index (ABI), but here exist few studies on long-term cardiovascular outcomes in patients with borderline ABI and even fewer on the general population.
Aim
The aim of the present study was to analyze the relationship between long-term cardiovascular events and low, borderline and normal ABI after a 9-year follow up of a Mediterranean population with low cardiovascular risk.
Design and setting
A population-based prospective cohort study was performed in the province of Barcelona, Spain.
Method
A total of 3,786 subjects >49 years were recruited from 2006-2008. Baseline ABI was 1.08 +/- 0.16. Subjects were followed from the time of enrollment to the end of follow-up in 2016 via phone calls every 6 months, systematic reviews of primary-care and hospital medical records and analysis of the SIDIAP (Information System for Primary Care Research) database to confirm the possible appearance of cardiovascular events.
Results
3146 individuals participated in the study. 2,420 (77%) subjects had normal ABI, 524 (17%) had borderline ABI, and 202 (6.4%) had low ABI.
In comparison with normal and borderline subjects, patients with lower ABI had more comorbidities, such as hypertension, hypercholesterolemia and diabetes.
Cumulative MACE incidence at 9 years was 20% in patients with low ABI, 6% in borderline ABI and 5% in normal ABI.
The annual MACE incidence after 9 years follow-up was significantly higher in people with low ABI (26.9/1000py) (p<0.001) than in borderline (6.6/1000py) and in normal ABI (5.6/1000py).
Subjects with borderline ABI are at significantly higher risk for coronary disease (HR: 1.58; 95% CI: 1.02-2, 43; p = 0,040) compared to subjects with normal ABI, after adjustment.
Conclusion
The results of the present study support that low ABI was independently associated with higher incidence of MACE, ICE, cardiovascular and no cardiovascular mortality; while borderline ABI had significantly moderate risk for coronary disease than normal ABI.
Filiaciones:
:
Inst Catala Salut, Direccio Atencio Primaria Barcelones Nord & Mares, Ctr Atencio Primaria Riu Nord Riu Sud Santa Colom, Barcelona, Spain
Inst Univ Invest Atencio Primaria Jordi Gol IDIAP, Unitat Suport Recerca Metropolitana Nord, Mataro, Spain
:
Inst Catala Salut, Direccio Atencio Primaria Barcelones Nord & Mares, Ctr Atencio Primaria Riu Nord Riu Sud Santa Colom, Barcelona, Spain
Inst Univ Invest Atencio Primaria Jordi Gol IDIAP, Unitat Suport Recerca Metropolitana Nord, Mataro, Spain
Univ Autonoma Barcelona, Bellaterra, Cerdanyola Del, Spain
Pera, G:
Inst Univ Invest Atencio Primaria Jordi Gol IDIAP, Unitat Suport Recerca Metropolitana Nord, Mataro, Spain
:
Inst Catala Salut, Direccio Atencio Primaria Barcelona Ciutat, Ctr Atencio Primaria La Marina, Barcelona, Spain
Inst Univ Invest Atencio Primaria Jordi Gol IDIAP, Unitat Suport Recerca Barcelona, Barcelona, Spain
:
Inst Univ Invest Atencio Primaria Jordi Gol IDIAP, Unitat Suport Recerca Barcelona, Barcelona, Spain
Hosp Nostra Senyora de Meritxell, Escaldes Engordany, Andorra
:
Inst Univ Invest Atencio Primaria Jordi Gol IDIAP, Unitat Suport Recerca Metropolitana Nord, Mataro, Spain
Green Published, gold, Green Submitted
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