Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Am Heart J. 2014 Apr;167(4):499-505. doi: 10.1016/j.ahj.2013.12.016. Epub 2014 Jan 4.
Ankle-brachial index (ABI) testing is a simple, noninvasive method to diagnose peripheral artery disease (PAD) and is associated with all-cause mortality. The association of ABI levels and myocardial infarction (MI) and stroke is less certain. We sought to further characterize the association between ABI levels and history of MI and stroke.
Using data from the Life Line Screening program, 3.6 million self-referred participants from 2003 to 2008 completed a medical questionnaire and had bilateral ABIs performed. Logistic regression was used to estimate the association between ABI cutoff points (ABI <0.90 and ABI >1.40) and ABI levels with history of MI, stroke, and MI or stroke (MI/stroke). Models were adjusted for age, sex, race/ethnicity, smoking, diabetes, hypertension, hypercholesterolemia, physical activity, and family history of cardiovascular disease. Separate sex-specific models were performed.
Overall, 155,552 (4.5%) had an ABI <0.90, and 42,890 (1.2%) had an ABI >1.40. An ABI <0.90 was associated with higher odds of MI (adjusted odds ratio [OR] 1.67, 95% CI 1.63-1.71), stroke (OR 1.77, 95% CI 1.72-1.82), and MI/stroke (OR 1.71, 95% CI 1.67-1.74), all P < .001. An ABI >1.40 was also associated with higher odds of MI (OR 1.19, 95% CI 1.14-1.24), stroke (OR 1.30, 95% CI 1.22-1.38), and MI/stroke (OR 1.22, 95% CI 1.17-1.27), all P < .001. The ORs for MI/stroke for different ABI levels formed a reverse J-shaped curve in both women and men.
In a large national screening database, there is a strong, consistent relationship between ABI levels and a history of prevalent MI, stroke, and MI/stroke.
踝臂指数（ABI）检测是一种简单、无创的方法，可用于诊断外周动脉疾病（PAD），并与全因死亡率相关。ABI 水平与心肌梗死（MI）和中风的关系则不太确定。我们试图进一步描述 ABI 水平与 MI 和中风病史之间的关系。
利用 Life Line Screening 计划的数据，2003 年至 2008 年期间，360 万自报名参加者完成了一份医学问卷，并进行了双侧 ABI 检测。采用 logistic 回归估计 ABI 截断点（ABI<0.90 和 ABI>1.40）和 ABI 水平与 MI 病史、中风、MI 或中风（MI/中风）之间的关联。模型调整了年龄、性别、种族/民族、吸烟、糖尿病、高血压、高胆固醇血症、身体活动和心血管疾病家族史。分别进行了性别特异性模型。
总体而言，155552 人（4.5%）的 ABI<0.90，42890 人（1.2%）的 ABI>1.40。ABI<0.90 与 MI（校正比值比[OR]1.67，95%置信区间[CI]1.63-1.71）、中风（OR 1.77，95%CI 1.72-1.82）和 MI/中风（OR 1.71，95%CI 1.67-1.74）的发生风险增加相关，所有 P<.001。ABI>1.40 也与 MI（OR 1.19，95%CI 1.14-1.24）、中风（OR 1.30，95%CI 1.22-1.38）和 MI/中风（OR 1.22，95%CI 1.17-1.27）的发生风险增加相关，所有 P<.001。在女性和男性中，不同 ABI 水平的 MI/中风比值形成了一个反向 J 形曲线。
在一个大型全国筛查数据库中，ABI 水平与 MI、中风和 MI/中风的既往病史之间存在强烈而一致的关系。
