Author + information
- Vishnu Priya Mallipeddi,
- Iftikhar Kullo,
- Naveed Afzal,
- Manju Kalra,
- Bradley Lewis,
- Christopher Scott,
- Hongfang Liu,
- Thom Rooke and
- Adelaide Arruda-Olson
Background: Peripheral artery disease (PAD) can lead to severe limb ischemia and limb loss. We conducted a community-based study to investigate the association of ankle brachial index (ABI) with incident limb outcomes in PAD patients.
Methods: We identified 1413 PAD cases in Olmsted County, Minnesota, from 1998 to 2011, followed until 2014. Limb outcomes were defined as limb revascularization (revasc) or limb amputation (amp). Poorly compressible arteries (PCA) were defined based on ABI≥1.4 or ankle systolic blood pressure >255 mm Hg and a resting ABI<0.5 was considered to indicate the presence of severe PAD. The remaining patients with PAD (resting ABI values 0.5-1.39) composed the reference group. We used Cox proportional hazards models to determine the association between ABI and limb outcomes.
Results: At a median follow-up of 6.3years, 350 (25%) had PCA, 283(20%) had severe PAD and 780 (59%) had ABI values from 0.5-1.39 among 1413 study subjects [Mean age:71±13 years, women 45%]. During follow-up, 5-year event rates for revasc were 10%, amp were 28%, both revasc and amp were 5%. After adjusting for hypertension, diabetes, chronic kidney disease, heart failure and statin therapy, severe PAD was associated with both revasc/amp whereas PCA was associated with amp only.
Conclusions: Severe PAD had increased risk of revasc as well as amp, whereas PCA was associated with risk of amp. Thereby, ABI results may be useful in identifying a subset of PAD patients who are at the greatest risk of adverse limb outcomes.
Multivariate Cox hazards model for limb outcomes
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Vascular Medicine: Aortic and Peripheral Artery Diseases
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1298-354
- 2017 American College of Cardiology Foundation