Ankle-brachial index and the incidence of all-cause mortality and cardiovascular morbidity in a prospective cohort study of a general population

Introduction: The aim of this study was to investigate the predictive value of the ankle-brachial index (ABI) in all-cause mortality and composite end-point all-cause mortality and cardiovascular morbidity in a sample of a general population. Methods: We performed a prospective cohort study of 1143 individuals free of cardiovascular events followed up for 10.8 years (SD = 2.2). The ABI was stratified in two levels: less than 0.9 and between 0.9 and 1.4. The predictive variables included in the adjustment were sex, age (cut-off: 50 years), hypertension, diabetes, obesity, hypercholesterolemia (cut-off: 200 mg/dl), high-density lipoprotein-cholesterol (HDLc)/triglyceride ratio, smoking and hyperfibrinogenemia. Kaplan-Meier survival curves and multivariate Cox proportional hazards analysis were used. Results: The mean age of the participants (56.8% female) was 47.1 years (SD = 17.4), range 18-91 years. An ABI value < 0.9 was found in 6.9% of the sample. After adjustment, an ABI of < 0.9 had a hazard ratio (HR) of 1.90 [ 95% confidence interval (CI) 1.10-3.26] for all-cause mortality, and an HR of 1.69 (95% CI 1.07-2.67) for composite all-cause mortality and cardiovascular morbidity. Conclusions: In our population, an ABI < 0.9 was a risk factor independent of all-cause mortality and of composite all-cause mortality and cardiovascular morbidity after a follow-up of 10.8 years. (C) 2010 Elsevier Espana, S.L. and SEA. All rights reserved.