Author + information
- Jason Strefling,
- Paul Zellers,
- Sridhar Venkatachalam,
- Ashley Lowry,
- Olcay Aksoy,
- Penny Houghtaling and
- Mehdi Shishehbor
A significant portion of patients with normal ankle–brachial index (ABI) at rest have abnormal post–exercise ABI. The morbidity and mortality associated with exercise induced drop in ABI is unknown.
This is a retrospective analysis of all individuals (n=2,842) who underwent resting ABI and post treadmill exercise ABI between 09/2005 and 01/2010 at a tertiary center. Three ABI cohorts were identified: normal rest/normal exercise (NR/NE, n=1,383), normal rest/abnormal exercise (NR/AE, n=479) and, abnormal rest/abnormal exercise (AR/AE, n=980). Abnormal ABI was defined as <0.9. The primary endpoint was MACE–R (death, stroke, myocardial infarction, lower extremity revascularization or amputation. Cox models were used to study adjusted outcomes.
Baseline comorbidities did not differ among the NR/NR and NR/AE cohorts. In total, 287 (10%) deaths occurred, with a step–wise increase in mortality across the NR/NE, NR/AE, and AR/AE groups (6.1%, 11%, and 15% respectively). A similar trend was seen for MACE–R (10%, 25%, and 44% respectively; Figure 1). In multivariable adjusted analysis, the NR/AE cohort in comparison to NR/NE had significantly increased risk of achieving the primary endpoint (adjusted hazard ratio (HR) 1.8; 95% confidence interval (CI): 1.4–2.4). The highest risk was noted among AR/AE individuals (adjusted HR 3.2; 95% CI: 2.5–4.1).
Post–exercise ABI is an important predictor of death, MACE, and MACE–R.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Atherosclerosis, Inflammation, Biomarkers and Outcomes: What's New?
Abstract Category: 35. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1124–163
- 2013 American College of Cardiology Foundation