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, 27 (7), 918-23

Noncompressible Arteries Correlate With Increased Cardiovascular Mortality at 2 Years

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Noncompressible Arteries Correlate With Increased Cardiovascular Mortality at 2 Years

Arya Amini et al. Ann Vasc Surg.

Abstract

Background: The ankle-brachial index (ABI) is a useful screening tool for the detection of peripheral vascular disease (PVD). Using ABI measurements, patients can be stratified into different severities of arterial occlusive disease.

Methods: Four hundred forty-four Veterans Health Administration Medical Center patients were referred for PVD between 2004 and 2005. Of those, 231 patients had an ABI ≤0.90 or >1.2 with known treatment and follow-up obtained from electronic medical records. These individuals had bilateral ABI measurements and were observed for a median of 23 months (range, 4.0-60.0 months). Patients were divided into 4 ABI categories: severe (ABI ≤0.30; n = 62), moderate (ABI 0.30-≤0.60; n = 138), mild (ABI 0.60-≤0.90; n = 89), normal (ABI 0.90-≤1.2; n = 86), and noncompressible (ABI >1.2; n = 69).

Results: Mortality from cardiovascular disease in the severe, moderate, mild, normal, and noncompressible groups was 4.8%, 8.0%, 10.1%, 0%, and 21.7%, respectively, at the mean follow-up of 2 years. For all-cause mortality, the overall percent for each group respectively was 32.3%, 31.9%, 31.5%, 14%, and 42% (P = 0.003). To our surprise, ABIs <0.9 did not show a linear correlation with 2-year survival. However, an ABI >1.2, indicating noncompressible arteries, correlated significantly with higher rates of mortality at a mean follow-up of 2 years (33.3%). Cardiovascular disease and amputation were also significantly higher in those with noncompressible arteries than in the other groups.

Conclusions: ABI is a noninvasive, inexpensive test that provides valuable information on a patient's risk of death. We recommend that patients with noncompressible vessels undergo systemic cardiovascular work-up, including coronary and carotid artery evaluation.

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