Association of Asymptomatic Low Ankle–Brachial Index with Long-Term Clinical Outcomes in Patients after Acute Myocardial Infarction

Aims: Peripheral arterial disease (PAD) is the well-known risk factor for cardiovascular events. Although low ankle–brachial index (ABI) is recognized as a risk factor in general population, low ABI without any symptoms of PAD has not been established as a prognostic marker in patients with acute my...

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Published in:Journal of Atherosclerosis and Thrombosis 2022/07/01, Vol.29(7), pp.992-1000
Main Authors: Ban, Soichiro, Sakakura, Kenichi, Jinnouchi, Hiroyuki, Taniguchi, Yousuke, Tsukui, Takunori, Watanabe, Yusuke, Yamamoto, Kei, Seguchi, Masaru, Wada, Hiroshi, Fujita, Hideo
Format: Article
Language:English
Subjects:
Acute myocardial infarction
Ankle Brachial Index
Humans
Myocardial Infarction - diagnosis
Myocardial Infarction - etiology
Original
Peripheral Arterial Disease - epidemiology
Peripheral artery disease
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Factors
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Summary:Aims: Peripheral arterial disease (PAD) is the well-known risk factor for cardiovascular events. Although low ankle–brachial index (ABI) is recognized as a risk factor in general population, low ABI without any symptoms of PAD has not been established as a prognostic marker in patients with acute myocardial infarction (AMI) yet. The purpose of this retrospective study was to examine whether asymptomatic low ABI was associated with long-term clinical outcomes in AMI patients without treatment history of PAD.Methods: We included 850 AMI patients without a history of PAD and divided them into the preserved ABI (ABI ≥ 0.9) group (n=760) and the reduced ABI (ABI ＜0.9) group (n=90) on the basis of the ABI measurement during the hospitalization. The primary endpoint was the major adverse cardiovascular events (MACE) defined as the composite of all-cause death, non-fatal myocardial infarction, and hospitalization for heart failure.Results: During the median follow-up duration of 497 days (Q1: 219 days to Q3: 929 days), a total of 152 MACE were observed. The Kaplan–Meier curves showed that MACE were more frequently observed in the reduced ABI group than in the preserved ABI group (p＜0.001). The multivariate COX hazard analysis revealed that reduced ABI was significantly associated with MACE (hazard ratio 2.046, 95% confidence interval 1.344–3.144, p=0.001) after controlling confounding factors.Conclusions: Reduced ABI was significantly associated with long-term adverse events in AMI patients without a history of PAD. Our results suggest the usefulness of ABI as a prognostic marker in AMI patients irrespective of symptomatic PAD.
ISSN:1340-3478
1880-3873
1880-3873
DOI:10.5551/jat.62998