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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

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 populati...

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Autores principales: Alzamora, M. Teresa, Forés, Rosa, Pera, Guillem, Baena-Díez, José Miguel, Valverde, Marta, Torán, Pere
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343871/
https://www.ncbi.nlm.nih.gov/pubmed/30673706
http://dx.doi.org/10.1371/journal.pone.0209163
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author Alzamora, M. Teresa
Forés, Rosa
Pera, Guillem
Baena-Díez, José Miguel
Valverde, Marta
Torán, Pere
author_facet Alzamora, M. Teresa
Forés, Rosa
Pera, Guillem
Baena-Díez, José Miguel
Valverde, Marta
Torán, Pere
author_sort Alzamora, M. Teresa
collection PubMed
description 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.
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spelling pubmed-63438712019-02-02 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 Alzamora, M. Teresa Forés, Rosa Pera, Guillem Baena-Díez, José Miguel Valverde, Marta Torán, Pere PLoS One Research Article 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. Public Library of Science 2019-01-23 /pmc/articles/PMC6343871/ /pubmed/30673706 http://dx.doi.org/10.1371/journal.pone.0209163 Text en © 2019 Alzamora et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Alzamora, M. Teresa
Forés, Rosa
Pera, Guillem
Baena-Díez, José Miguel
Valverde, Marta
Torán, Pere
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343871/
https://www.ncbi.nlm.nih.gov/pubmed/30673706
http://dx.doi.org/10.1371/journal.pone.0209163
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