Decrease in Ankle-Brachial Index Over Time and Cardiovascular Outcomes in Patients With Hemodialysis

作者：Chen Szu Chia; Chang Jer Ming; Liu Wan Chun; Huang Jiun Chi; Chen Yi Yu; Yang Tsung Kun; Su Ho Ming^*; Chen Hung Chun

来源：American Journal of the Medical Sciences, 2012, 344(6): 457-461.

DOI：10.1097/MAJ.0b013e31825141bf

• Ankle-brachial index decrease
• Cardiovascular events
• Hemodialysis

Introduction: Abnormal ankle-brachial index (ABI) is associated with increased morbidity and mortality in hemodialysis patients. However, whether the decrease in ABI over time carries the prognostic value is unknown. The aim of this study was to assess whether the decrease in ABI over time was a good predictor of poor cardiovascular (CV) prognosis in hemodialysis patients. Methods: This study enrolled 234 routine hemodialysis patients and 173 patients completed the follow-up. The ABI was measured by an ABI-form device at baseline and at the first year follow-up. The Delta ABI was defined as ABI measured at the first year follow-up minus ABI measured at baseline. Progressors of ABI were defined as patients with Delta ABI %26lt; -0.3. CV events were defined as CV death, hospitalization for unstable angina, nonfatal myocardial infarction, hospitalization for arrhythmia, hospitalization for congestive heart failure and stroke. Results: The follow-up period was 37.8 +/- 11.1 months. In the multivariate analysis, progressors of ABI (hazard ratio, 2.71; 95% confidence interval, 1.10-6.68, P = 0.03), decreased albumin and increased high-sensitivity C-reactive protein were associated with increased CV events. Conclusions: This longitudinal study showed Delta ABI %26lt; -0.3 was independently associated with an increase in CV events. Hence, a great decrease in ABI over time might be a useful indicator of poor CV prognosis in hemodialysis patients.

• 出版日期2012-12