Brachial-ankle pulse wave velocity, but not ankle-brachial index, predicts all-cause mortality in patients with diabetes after lower extremity amputation

We examined whether brachial-ankle pulse wave velocity (baPWV) and ankle-brachial pressure index (ABI) are predictors for mortality in diabetic patients after lower extremity amputation. This was an observational historical cohort study of 102 Japanese diabetic patients after first non-traumatic lower extremity amputation, with a mean age of 63 years (standard deviation 12 years). The end-point was all-cause mortality. During the mean follow-up period of 3.3 years, 44 patients reached the end-point. In both univariate and multivariate analyses, baPWV (m/s) (hazard ratio [HR] 1.05 and 1.04, both P < 0.01, respectively), but not ABI (HR 0.38 and 0.89, P = 0.08 and 0.86, respectively), was a significant predictor for the end-point. When baPWV (above or below the median [21.8 m/s]) and ABI (normal [0.9-1.4] or not) were analyzed as categorical variables, the results were similar. In conclusion, baPWV, but not ABI, might be a predictor for all-cause mortality in diabetic patients after lower extremity amputation.