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THE EFFECT OF INCREASE IN POST-EXERCISE ANKLE-BRACHIAL INDEX AMONG PATIENTS WITH NORMAL RESTING RESULTS
2244 JACC April 5, 2016 Volume 67, Issue 13
Vascular Medicine THE EFFECT OF INCREASE IN POST-EXERCISE ANKLE-BRACHIAL INDEX AMONG PATIENTS WITH NORMAL RESTING RESULTS Moderated Poster Contributions Vascular Medicine Moderated Poster Theater, Poster Area, South Hall A1 Saturday, April 02, 2016, 3:45 p.m.-3:55 p.m. Session Title: Challenges in the Care of Patients With Peripheral Artery Disease: Right Patient, Right Care, Right Time Abstract Category: 44. Vascular Medicine: Non Coronary Arterial Disease Presentation Number: 1164M-01 Authors: Tarek Hammad, William Hiatt, Heather Gornik, Mehdi Shishehbor, Cleveland Clinic, Cleveland, OH, USA
Background: Prior studies assessed the effect of post-exercise ankle-brachial index (ABI) drop in patients with normal resting results. However, none have evaluated the effect of its increase in these patients.
Methods: From a single center vascular laboratory database between 09/2005 and 01/2010, we retrospectively identified 1,813 consecutive patients with normal resting ABI (0.91-1.4) and available post-exercise results. We classified them based on the latter into: group 1 (normal subjects; post-exercise ABI drop ≤ 20%) and group 2 (post-exercise ABI increase), those with peripheral artery disease (ABI drop > 20%) were excluded (n=343). Primary outcome was a composite of death, stroke, or myocardial infraction (MACE). Association between groups and outcome was tested using multivariable Cox proportional hazard and propensity analyses. Results: Both groups had similar prevalence of cardiovascular comorbidities. In unadjusted analysis, there was a significant difference in the incidence of MACE (Figure). After adjusting for all baseline characteristics, increase in post-exercise ABI, compared to normal subject, was associated with a trend toward higher MACE (adjusted HR: 1.39, 95% CI: 0.98-1.99; P=0.07). However, this association became statistically significant after propensity matching (adjusted HR: 1.63, 95% CI: 1.11-2.39; P=0.01). Conclusions: This hypothesis generating analysis showed that an increase in post-exercise ABI appears to identify a population with higher risk for MACE.
Vascular Medicine THE EFFECT OF INCREASE IN POST-EXERCISE ANKLE-BRACHIAL INDEX AMONG PATIENTS WITH NORMAL RESTING RESULTS Moderated Poster Contributions Vascular Medicine Moderated Poster Theater, Poster Area, South Hall A1 Saturday, April 02, 2016, 3:45 p.m.-3:55 p.m. Session Title: Challenges in the Care of Patients With Peripheral Artery Disease: Right Patient, Right Care, Right Time Abstract Category: 44. Vascular Medicine: Non Coronary Arterial Disease Presentation Number: 1164M-01 Authors: Tarek Hammad, William Hiatt, Heather Gornik, Mehdi Shishehbor, Cleveland Clinic, Cleveland, OH, USA
Background: Prior studies assessed the effect of post-exercise ankle-brachial index (ABI) drop in patients with normal resting results. However, none have evaluated the effect of its increase in these patients.
Methods: From a single center vascular laboratory database between 09/2005 and 01/2010, we retrospectively identified 1,813 consecutive patients with normal resting ABI (0.91-1.4) and available post-exercise results. We classified them based on the latter into: group 1 (normal subjects; post-exercise ABI drop ≤ 20%) and group 2 (post-exercise ABI increase), those with peripheral artery disease (ABI drop > 20%) were excluded (n=343). Primary outcome was a composite of death, stroke, or myocardial infraction (MACE). Association between groups and outcome was tested using multivariable Cox proportional hazard and propensity analyses. Results: Both groups had similar prevalence of cardiovascular comorbidities. In unadjusted analysis, there was a significant difference in the incidence of MACE (Figure). After adjusting for all baseline characteristics, increase in post-exercise ABI, compared to normal subject, was associated with a trend toward higher MACE (adjusted HR: 1.39, 95% CI: 0.98-1.99; P=0.07). However, this association became statistically significant after propensity matching (adjusted HR: 1.63, 95% CI: 1.11-2.39; P=0.01). Conclusions: This hypothesis generating analysis showed that an increase in post-exercise ABI appears to identify a population with higher risk for MACE.