doi: 10.2169/internalmedicine.8215-16 Intern Med 56: 2103-2111, 2017 http://internmed.jp
【 ORIGINAL ARTICLE 】
Ankle-brachial Index for the Prognosis of Cardiovascular Disease in Patients with Mild Renal Insufficiency Hitoshi Nishimura, Takashi Miura, Masatoshi Minamisawa, Yasushi Ueki, Naoyuki Abe, Naoto Hashizume, Tomoaki Mochidome, Mikiko Harada, Kunihiko Shimizu, Wataru Shoin, Koji Yoshie, Yasutaka Oguchi, Soichiro Ebisawa, Hirohiko Motoki, Atsushi Izawa, Jun Koyama, Uichi Ikeda and Koichiro Kuwahara
Abstract: Objective A low ankle-brachial index (ABI) is a known predictor for future cardiovascular events and mortality in patients with chronic kidney disease (CKD). While most prior studies have defined CKD as an estimated glomerular filtration rate (eGFR) 0.9 89 mL/min/1.73 m2), and stratified them into 2 groups: ABI ! (90.8%). The primary outcome measured was the cumulative incidence of major adverse cardiovascular events (MACE; cardiovascular death, myocardial infarction, and stroke). Results Over a mean follow-up of 5.0 years, 101 MACE occurred. The incidence of MACE was significantly higher in patients with low ABI than in those with ABI >0.9 (30.2% vs. 14.4%, log rank p0.9 (30.2% vs.
2105
Intern Med 56: 2103-2111, 2017
DOI: 10.2169/internalmedicine.8215-16
Table 1. Baseline Characteristics. Variables
Overall (N)
ABI≤0.9
ABI>0.9
p value
1,500
138
1,362
Age (years) Female sex ABI Body mass index (kg/m2) Hypertension Dyslipidemia Diabetes mellitus Smoking habit eGFR (mL/min/1.73 m2) Atrial fibrillation Anemia Coronary heart disease Previous myocardial infarction Previous cerebral infarction Previous heart failure Left ventricle ejection fraction BNP (pg/mL)
68 (59–75) 449 (29.9%) 1.12 (1.04–1.17) 23.3 (21.2–25.5) 834 (55.6%) 667 (44.5%) 348 (23.2%) 677 (45.1%) 71.8 (65.6–79.0) 172 (11.4%) 203 (13.5%) 262 (17.4%) 211 (14.0%) 83 (5.5%) 81 (5.4%) 69 (60.6–75.3) 39.9 (18.5–93.3)
73 (65–79) 28 (20.2%) 0.68 (0.56–0.80) 22.2 (20.4–23.9) 93 (67.4%) 64 (46.3%) 48 (34.7%) 92 (66.6%) 72.5 (65.2–79.0) 17 (12.3%) 28 (20.3%) 32 (23.1%) 15 (10.8%) 16 (11.5%) 8 (5.7%) 68.7 (62.2–76.8) 47.7 (21.0–95.0)
67 (59–75) 421 (30.9%) 1.13 (1.07–1.18) 23.4 (21.4–25.7) 741 (54.4%) 603 (44.2%) 300 (22.0%) 585 (42.9%) 71.8 (65.8–79.0) 155 (11.3%) 175 (12.8%) 230 (16.8%) 196 (14.3%) 67 (4.9%) 73 (5.3%) 69.0 (60.6–75.3) 39.8 (18.3–95.1)
【 ORIGINAL ARTICLE 】
Ankle-brachial Index for the Prognosis of Cardiovascular Disease in Patients with Mild Renal Insufficiency Hitoshi Nishimura, Takashi Miura, Masatoshi Minamisawa, Yasushi Ueki, Naoyuki Abe, Naoto Hashizume, Tomoaki Mochidome, Mikiko Harada, Kunihiko Shimizu, Wataru Shoin, Koji Yoshie, Yasutaka Oguchi, Soichiro Ebisawa, Hirohiko Motoki, Atsushi Izawa, Jun Koyama, Uichi Ikeda and Koichiro Kuwahara
Abstract: Objective A low ankle-brachial index (ABI) is a known predictor for future cardiovascular events and mortality in patients with chronic kidney disease (CKD). While most prior studies have defined CKD as an estimated glomerular filtration rate (eGFR) 0.9 89 mL/min/1.73 m2), and stratified them into 2 groups: ABI ! (90.8%). The primary outcome measured was the cumulative incidence of major adverse cardiovascular events (MACE; cardiovascular death, myocardial infarction, and stroke). Results Over a mean follow-up of 5.0 years, 101 MACE occurred. The incidence of MACE was significantly higher in patients with low ABI than in those with ABI >0.9 (30.2% vs. 14.4%, log rank p0.9 (30.2% vs.
2105
Intern Med 56: 2103-2111, 2017
DOI: 10.2169/internalmedicine.8215-16
Table 1. Baseline Characteristics. Variables
Overall (N)
ABI≤0.9
ABI>0.9
p value
1,500
138
1,362
Age (years) Female sex ABI Body mass index (kg/m2) Hypertension Dyslipidemia Diabetes mellitus Smoking habit eGFR (mL/min/1.73 m2) Atrial fibrillation Anemia Coronary heart disease Previous myocardial infarction Previous cerebral infarction Previous heart failure Left ventricle ejection fraction BNP (pg/mL)
68 (59–75) 449 (29.9%) 1.12 (1.04–1.17) 23.3 (21.2–25.5) 834 (55.6%) 667 (44.5%) 348 (23.2%) 677 (45.1%) 71.8 (65.6–79.0) 172 (11.4%) 203 (13.5%) 262 (17.4%) 211 (14.0%) 83 (5.5%) 81 (5.4%) 69 (60.6–75.3) 39.9 (18.5–93.3)
73 (65–79) 28 (20.2%) 0.68 (0.56–0.80) 22.2 (20.4–23.9) 93 (67.4%) 64 (46.3%) 48 (34.7%) 92 (66.6%) 72.5 (65.2–79.0) 17 (12.3%) 28 (20.3%) 32 (23.1%) 15 (10.8%) 16 (11.5%) 8 (5.7%) 68.7 (62.2–76.8) 47.7 (21.0–95.0)
67 (59–75) 421 (30.9%) 1.13 (1.07–1.18) 23.4 (21.4–25.7) 741 (54.4%) 603 (44.2%) 300 (22.0%) 585 (42.9%) 71.8 (65.8–79.0) 155 (11.3%) 175 (12.8%) 230 (16.8%) 196 (14.3%) 67 (4.9%) 73 (5.3%) 69.0 (60.6–75.3) 39.8 (18.3–95.1)
