1 Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
2 Department of Cardiology, Nagano Red Cross Hospital, Nagano, Japan.
Angiology. 2017 Nov;68(10):884-892. doi: 10.1177/0003319717697883. Epub 2017 Mar 10.
Concomitant coronary and peripheral artery disease is associated with higher periprocedural and long-term percutaneous coronary intervention (PCI) complication rates. We evaluated in-hospital and 1-year clinical outcomes of patients with low or borderline ankle-brachial indexes (ABIs) undergoing PCIs in the drug-eluting stent era. We divided 1370 SHINANO registry patients into 3 groups-low (ABI ≤ 0.9), borderline (0.9 < ABI ≤ 1.0), and normal (1.0 ≤ ABI < 1.4). During the 1-year follow-up, more PCI-related complications occurred in the low and borderline ABI groups than in the normal ABI group (7.7% vs 8.8% vs 4.0%, respectively). Low ABI patients were more likely to experience adverse clinical events (6.3% vs 3.6% vs 3.0%, respectively; log-rank P = .020 for low vs normal ABI), with a hazard ratio of 2.27 (95% confidence interval, 1.12-4.61; P = .023), compared with patients with normal ABIs. Patients with abnormal ABIs had a significantly higher incidence of PCI-related complications and a less favorable 1-year prognosis. Routine ABI measurement before PCI may help predict PCI-related complication incidence and 1-year prognosis.
同时患有冠状动脉和外周动脉疾病与经皮冠状动脉介入治疗(PCI)围手术期和长期并发症发生率较高相关。我们评估了药物洗脱支架时代接受 PCI 的低或临界踝臂指数(ABI)患者的住院期间和 1 年临床结局。我们将 1370 例 SHINANO 注册患者分为 3 组:低(ABI≤0.9)、临界(0.9<ABI≤1.0)和正常(1.0<ABI<1.4)。在 1 年随访期间,低和临界 ABI 组的 PCI 相关并发症发生率高于正常 ABI 组(分别为 7.7%、8.8%和 4.0%)。低 ABI 患者更易发生不良临床事件(分别为 6.3%、3.6%和 3.0%;低 ABI 与正常 ABI 相比,log-rank P=.020),其风险比为 2.27(95%置信区间,1.12-4.61;P=.023),与正常 ABI 患者相比。ABI 异常的患者 PCI 相关并发症发生率较高,1 年预后较差。PCI 前常规测量 ABI 可能有助于预测 PCI 相关并发症发生率和 1 年预后。