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Combination of low ankle-brachial index and high ankle-brachial index difference for mortality prediction

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Abstract

Low ankle-brachial index (ABI) and high ABI difference (ABID) are each associated with poor prognosis. No study has assessed the ability of the combination of low ABI and high ABID to predict survival. We created an ABI score by assigning 1 point for ABI < 0.9 and 1 point for ABID ≥ 0.17 and examine the ability of this ABI score to predict mortality. We included 941 patients scheduled for echocardiographic examination. The ABI was measured using an ABI-form device. ABID was calculated as |right ABI–left ABI|. Among the 941 subjects, the prevalence of ABI < 0.9 and ABID ≥ 0.17 was 6.1% and 6.8%, respectively. Median follow-up to mortality was 93 months. There were 87 cardiovascular and 228 overall deaths. All ABI-related parameters, including ABI, ABID, ABI < 0.9, ABID ≥ 0.17, and ABI score, were significantly associated with overall and cardiovascular mortality in the multivariable analysis (P ≤ 0.009). Further, in the direct comparison of multivariable models, the basic model + ABI score was the best at predicting overall and cardiovascular mortality among the five ABI-related multivariable models (P ≤ 0.049). Hence, the ABI score, a combination of ABI < 0.9 and ABID ≥ 0.17, should be calculated for better mortality prediction.

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Acknowledgements

Mortality data were provided by the Collaboration Center of Health Information Application, Ministry of Health and Welfare, Executive Yuan.

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Authors and Affiliations

  1. Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Wei-Chung Tsai, Wen-Hsien Lee, Yi-Hsueh Liu, Ching-Tang Chang, Chun-Yuan Chu & Ho-Ming Su

  2. Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Wei-Chung Tsai, Wen-Hsien Lee, Ying-Chih Chen, Yi-Hsueh Liu, Ching-Tang Chang, Po-Chao Hsu, Chun-Yuan Chu, Tsung-Hsien Lin, Chee-Siong Lee, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu & Ho-Ming Su

  3. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Wei-Chung Tsai, Wen-Hsien Lee, Po-Chao Hsu, Chun-Yuan Chu, Tsung-Hsien Lin, Chee-Siong Lee, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu & Ho-Ming Su

  4. Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan

    Wen-Hsien Lee, Ying-Chih Chen, Yi-Hsueh Liu & Ho-Ming Su

  5. Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chien-Hung Lee

  6. Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chien-Hung Lee

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  1. Wei-Chung Tsai
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Tsai, WC., Lee, WH., Chen, YC. et al. Combination of low ankle-brachial index and high ankle-brachial index difference for mortality prediction. Hypertens Res 44, 850–857 (2021). https://doi.org/10.1038/s41440-021-00636-y

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