Document Detail


Asymptomatic low ankle-brachial index in vascular surgery patients: a predictor of perioperative myocardial damage.
MedLine Citation:
PMID:  19815432     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study evaluated the prognostic value of asymptomatic low ankle-brachial index (ABI) to predict perioperative myocardial damage, incremental to conventional cardiac risk factors imbedded in cardiac risk indices (Revised Cardiac index and Adapted Lee index).
MATERIALS AND METHODS: Preoperative ABI measurements were performed in 627 consecutive vascular surgery patients (carotid artery or abdominal aortic aneurysm repair). An ABI<0.90 was considered abnormal. Patients with ABI>1.40 or (a history of) intermittent claudication were excluded. Serial troponin-T measurements were performed routinely before and after surgery. The main study endpoint was perioperative myocardial damage, the composite of myocardial ischaemia and infarction. Multivariate regression analyses, adjusted for conventional risk factors, evaluated the relation between asymptomatic low ABI and perioperative myocardial damage.
RESULTS: In total, 148 (23%) patients had asymptomatic low ABI (mean 0.73, standard deviation+/-0.13). Perioperative myocardial damage was recorded in 107 (18%) patients. Multivariate regression analyses demonstrated that asymptomatic low ABI was associated with an increased risk of perioperative myocardial damage (odds ratio (OR): 2.4, 95% CI: 1.4-4.2) CONCLUSIONS: This study demonstrated that asymptomatic low ABI has a prognostic value to predict perioperative myocardial damage in vascular surgery patients, incremental to risk factors imbedded in conventional cardiac risk indices.
Authors:
W-J Flu; J-P van Kuijk; M T Voûte; R Kuiper; H J M Verhagen; J J Bax; D Poldermans
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-07
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  39     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-02-25     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  62-9     Citation Subset:  IM    
Copyright Information:
Copyright 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Ankle / blood supply*
Aortic Aneurysm, Abdominal / mortality,  physiopathology,  surgery*
Biological Markers / blood
Blood Pressure*
Brachial Artery / physiopathology*
Carotid Stenosis / mortality,  physiopathology,  surgery*
Female
Heart Diseases / blood,  etiology*,  mortality,  pathology
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardium / metabolism,  pathology*
Odds Ratio
Predictive Value of Tests
Prevalence
Proportional Hazards Models
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Troponin T / blood
Vascular Surgical Procedures / adverse effects*,  mortality
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin T

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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