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Exercise ankle brachial index adds important prognostic information on long-term out-come only in patients with a normal resting ankle brachial index.
MedLine Citation:
PMID:  21397231     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The clinical value of exercise ankle brachial index (ABI) is still unclear, especially in patients with normal resting ABI. METHOD: 2164 patients performed a single-stage treadmill exercise test to diagnose or evaluate PAD. The population was divided into two groups: a normal resting ABI (resting ABI≥0.90) and PAD (resting ABI<0.90). Patients with a normal resting ABI were divided into 4 exercise ABI groups: exercise ABI<0.90, 0.90-0.99, 1.00-1.09 and 1.10-1.29 (reference). RESULTS: Mean follow-up was 5years. Exercise ABI added significant prognostic information on all cause long-term mortality only in patients with normal resting ABI (p-value 0.014, HR 0.99 95% CI (0.98-0.99)), not in patients with PAD. Fifty years or older (OR 2.93 95% CI (1.65-5.20)) and resting systolic blood pressure>140mmHg (OR 2.18 95% CI (1.35-3.55)) were associated with an abnormal exercise ABI in patients with a normal resting ABI. Mortality rate increased when the exercise ABI became worse (p trend 0.0001) with a 2.5-fold increase mortality risk in patients with a normal resting ABI but exercise ABI <0.90 (HR 2.56, 95% CI (1.11-5.91)). CONCLUSION: In patients with a normal resting ABI, treadmill exercise ABI added important prognostic information on long-term mortality. Based on our results we recommend that at least all patients suspected for PAD, with a resting ABI≥0.90, who are 50years or older and having hypertension should undergo treadmill exercise testing.
Authors:
Inge I de Liefde; Jan Klein; Jeroen J Bax; Hence J M Verhagen; Ron T van Domburg; Don Poldermans
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-24
Journal Detail:
Title:  Atherosclerosis     Volume:  -     ISSN:  1879-1484     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-3-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Anesthesiology, Erasmus MC, Rotterdam, The Netherlands.
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