Abstract
Ankle-brachial indices (ABIs) are important for the assessment of disease burden among patients with peripheral artery disease. Although low values have been associated with adverse clinical outcomes, the association between non-compressible ABI (ncABI) and clinical outcome has not been evaluated among patients with critical limb ischemia (CLI). The present study sought to compare the clinical characteristics, angiographic findings and clinical outcomes of those with compressible (cABI) and ncABI among patients with CLI. Consecutive patients undergoing endovascular evaluation for CLI between 2006 and 2013 were included in a single center cohort. Major adverse cardiovascular events (MACE) were then compared between the two groups. Among 284 patients with CLI, 68 (24%) had ncABIs. These patients were more likely to have coronary artery disease (p=0.003), diabetes (p<0.001), end-stage renal disease (p<0.001) and tissue loss (p=0.01) when compared to patients with cABI. Rates of infrapopliteal disease were similar between the two groups (p=0.10), though patients with ncABI had lower rates of iliac (p=0.004) or femoropopliteal stenosis (p=0.003). Infrapopliteal vessels had smaller diameters (p=0.01) with longer lesions (p=0.05) among patients with ncABIs. After 3 years of follow-up, ncABIs were associated with increased rates of mortality (HR 1.75, 95% CI: 1.12-2.78), MACE (HR 2.04, 95% CI: 1.35-3.03) and major amputation (HR 1.96, 95% CI: 1.11-3.45) when compared to patients with cABIs. In conclusion, ncABIs are associated with higher rates of mortality and adverse events among those undergoing endovascular therapy for CLI.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 210-217 |
| Number of pages | 8 |
| Journal | Vascular Medicine (United Kingdom) |
| Volume | 22 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2017 |
Fingerprint
Keywords
- amputation
- ankle-brachial index (ABI)
- critical limb ischemia (CLI)
- endovascular therapy
- lower extremity
- peripheral artery disease (PAD)
- vascular diseases
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Non-compressible ABIs are associated with an increased risk of major amputation and major adverse cardiovascular events in patients with critical limb ischemia. / Singh, Gagan; Armstrong, Ehrin J.; Waldo, Stephen W.; Alvandi, Bejan; Brinza, Ellen; Hildebrand, Justin; Amsterdam, Ezra A; Humphries, Misty; Laird, John R.
In: Vascular Medicine (United Kingdom), Vol. 22, No. 3, 2017, p. 210-217.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Non-compressible ABIs are associated with an increased risk of major amputation and major adverse cardiovascular events in patients with critical limb ischemia
AU - Singh, Gagan
AU - Armstrong, Ehrin J.
AU - Waldo, Stephen W.
AU - Alvandi, Bejan
AU - Brinza, Ellen
AU - Hildebrand, Justin
AU - Amsterdam, Ezra A
AU - Humphries, Misty
AU - Laird, John R.
PY - 2017
Y1 - 2017
N2 - Ankle-brachial indices (ABIs) are important for the assessment of disease burden among patients with peripheral artery disease. Although low values have been associated with adverse clinical outcomes, the association between non-compressible ABI (ncABI) and clinical outcome has not been evaluated among patients with critical limb ischemia (CLI). The present study sought to compare the clinical characteristics, angiographic findings and clinical outcomes of those with compressible (cABI) and ncABI among patients with CLI. Consecutive patients undergoing endovascular evaluation for CLI between 2006 and 2013 were included in a single center cohort. Major adverse cardiovascular events (MACE) were then compared between the two groups. Among 284 patients with CLI, 68 (24%) had ncABIs. These patients were more likely to have coronary artery disease (p=0.003), diabetes (p<0.001), end-stage renal disease (p<0.001) and tissue loss (p=0.01) when compared to patients with cABI. Rates of infrapopliteal disease were similar between the two groups (p=0.10), though patients with ncABI had lower rates of iliac (p=0.004) or femoropopliteal stenosis (p=0.003). Infrapopliteal vessels had smaller diameters (p=0.01) with longer lesions (p=0.05) among patients with ncABIs. After 3 years of follow-up, ncABIs were associated with increased rates of mortality (HR 1.75, 95% CI: 1.12-2.78), MACE (HR 2.04, 95% CI: 1.35-3.03) and major amputation (HR 1.96, 95% CI: 1.11-3.45) when compared to patients with cABIs. In conclusion, ncABIs are associated with higher rates of mortality and adverse events among those undergoing endovascular therapy for CLI.
AB - Ankle-brachial indices (ABIs) are important for the assessment of disease burden among patients with peripheral artery disease. Although low values have been associated with adverse clinical outcomes, the association between non-compressible ABI (ncABI) and clinical outcome has not been evaluated among patients with critical limb ischemia (CLI). The present study sought to compare the clinical characteristics, angiographic findings and clinical outcomes of those with compressible (cABI) and ncABI among patients with CLI. Consecutive patients undergoing endovascular evaluation for CLI between 2006 and 2013 were included in a single center cohort. Major adverse cardiovascular events (MACE) were then compared between the two groups. Among 284 patients with CLI, 68 (24%) had ncABIs. These patients were more likely to have coronary artery disease (p=0.003), diabetes (p<0.001), end-stage renal disease (p<0.001) and tissue loss (p=0.01) when compared to patients with cABI. Rates of infrapopliteal disease were similar between the two groups (p=0.10), though patients with ncABI had lower rates of iliac (p=0.004) or femoropopliteal stenosis (p=0.003). Infrapopliteal vessels had smaller diameters (p=0.01) with longer lesions (p=0.05) among patients with ncABIs. After 3 years of follow-up, ncABIs were associated with increased rates of mortality (HR 1.75, 95% CI: 1.12-2.78), MACE (HR 2.04, 95% CI: 1.35-3.03) and major amputation (HR 1.96, 95% CI: 1.11-3.45) when compared to patients with cABIs. In conclusion, ncABIs are associated with higher rates of mortality and adverse events among those undergoing endovascular therapy for CLI.
KW - amputation
KW - ankle-brachial index (ABI)
KW - critical limb ischemia (CLI)
KW - endovascular therapy
KW - lower extremity
KW - peripheral artery disease (PAD)
KW - vascular diseases
UR - http://www.scopus.com/inward/record.url?scp=85019197671&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019197671&partnerID=8YFLogxK
U2 - 10.1177/1358863X16689831
DO - 10.1177/1358863X16689831
M3 - Article
C2 - 28466753
AN - SCOPUS:85019197671
VL - 22
SP - 210
EP - 217
JO - Vascular Medicine (United Kingdom)
JF - Vascular Medicine (United Kingdom)
SN - 1358-863X
IS - 3
ER -