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Decrease in ankle-brachial index over time and cardiovascular outcomes in patients with hemodialysis.
MedLine Citation:
PMID:  23190561     Owner:  NLM     Status:  In-Data-Review    
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 ΔABI was defined as ABI measured at the first year follow-up minus ABI measured at baseline. Progressors of ABI were defined as patients with ΔABI < -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 ΔABI < -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.
Szu-Chia Chen; Jer-Ming Chang; Wan-Chun Liu; Jiun-Chi Huang; Yi-Yu Chen; Tsung-Kun Yang; Ho-Ming Su; Hung-Chun Chen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  344     ISSN:  1538-2990     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  457-61     Citation Subset:  AIM; IM    
Divisions of Nephrology (S-CC, J-MC, W-CL, J-CH, T-KY, H-CC) and Cardiology (H-MS), Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University; Department of Internal Medicine (S-CC, J-MC, W-CL, Y-YC, H-MS), Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University; and Departments of Renal Care (J-MC, H-CC) and Medicine (H-MS), College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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