This article is more than 5 years old. Information may no longer be current.
Post-exercise ABI linked to lower-extremity revascularization
Click Here to Manage Email Alerts
Among patients with normal or abnormal resting ankle-brachial index, abnormal post-exercise ankle-brachial index testing was associated with an increased incidence of lower-extremity revascularization.
“In this retrospective study, post-exercise [ankle-brachial index] appears to offer clinical and prognostic information beyond normal and abnormal resting [ankle-brachial index],” the researchers wrote.
The study included 2,791 consecutive patients who underwent ankle-brachial index (ABI) testing from September 2005 to January 2010.
The researchers classified patients into the following four ABI subgroups:
- normal resting (NR)/normal post-exercise (NE; n = 1,462);
- NR/abnormal post-exercise (AE; n = 350);
- abnormal resting (AR)/NE (n = 219); or
- AR/AE (n = 759).
Abnormal post-exercise ABI was defined as a decrease of more than 20% from resting ABI, according to American College of Cardiology/American Heart Association guidelines.
Incidence of lower-extremity revascularization served as the primary endpoint, and MACE and all-cause mortality were the secondary endpoints.
Results indicated that compared with the NR/NE group, the NR/AE group had a significant increase in lower-extremity revascularization (adjusted HR = 6.63; 95% CI, 3.13-14.04), but not in MACE or all-cause mortality. An increase in lower-extremity revascularization also was found in AR/AE patients when compared with AR/NE patients (adjusted HR = 1.59; 95% CI, 1.11-2.28), which remained after propensity matching (adjusted HR = 2.32; 95% CI, 1.52-3.54).
Additional propensity-matched data revealed that compared with the NR/NE arm, the AR/AE arm had a higher rate of MACE (adjusted HR = 1.44; 95% CI, 1.09-1.9), and there was a trend toward an increase in all-cause mortality (adjusted HR = 1.37; 95% CI, 0.99-1.88). However, there were no significant differences with the secondary endpoints when researchers compared the AR/NE and AR/AE groups.
“Post-exercise ABI can be performed in the office setting, is relatively safe and provides objective perfusion assessment at the time of claudication symptoms,” the researchers concluded. “Future properly conducted prospective studies should confirm the diagnostic and prognostic utility of exercise ABI; however, at the present time, our results support the utilization of this test among patients with suspected [peripheral artery disease], even when resting ABI is abnormal.” – by Brian Ellis
Disclosure: One researcher reports intellectual property rights with Doppler Systems. The other researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts