Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Int J Med Sci. 2021 Jan 1;18(1):65-72. doi: 10.7150/ijms.50831. eCollection 2021.
No study has investigated the predictive ability of ankle-brachial index (ABI) calculated using diastolic blood pressure (DBP) (ABIdbp) and mean arterial pressure (MAP) (ABImap) for overall and cardiovascular (CV) mortality in hemodialysis (HD) patients. Our study was aimed to investigate the issue. Two hundred and seven routine HD patients were enrolled. ABI values were measured by ABI-form device. During the follow-up period (122 months), 124 of the 207 patients (59.0%) died, and 59 deaths due to CV cause. Multivariate analysis showed that low ABIsbp, ABIdbp, and ABImap were all significantly associated with increased overall ( ≤ 0.015) and CV mortality ( ≤ 0.015) in whole study patients. A subgroup analysis after excluding 37 patients with ABIsbp < 0.9 or > 1.3 found ABIsbp and ABIsbp < 0.9 were not associated with overall and CV mortality. However, ABImap and ABIdbp < 0.87 were significantly associated with overall mortality ( ≤ 0.042). Furthermore, ABIdbp and ABIdbp < 0.87 were significantly associated with CV mortality ( ≤ 0.030). In conclusion, ABIsbp, ABIdbp, and ABImap were all useful in predicting overall and CV mortality in our HD patients. In the subgroup patients with normal ABIsbp, ABIsbp and ABIsbp < 0.9 were not useful to predict overall and CV mortality. Nevertheless, ABImap and ABIdbp < 0.87 could still predict overall mortality, and ABIdbp and ABIdbp < 0.87 could predict CV mortality. Hence, calculating ABI using DBP and MAP may provide benefit in survival prediction in HD patients, especially in the patients with normal ABIsbp.
尚无研究调查使用舒张压（DBP）（ABIdbp）和平均动脉压（MAP）（ABImap）计算的踝臂指数（ABI）对血液透析（HD）患者全因和心血管（CV）死亡率的预测能力。我们的研究旨在探讨这个问题。纳入了 207 名常规 HD 患者。使用 ABI 仪测量 ABI 值。在随访期间（122 个月），207 名患者中有 124 名（59.0%）死亡，59 例死于 CV 原因。多变量分析显示，低 ABI sbp、ABI dbp 和 ABImap 均与全组患者全因（≤0.015）和 CV 死亡率（≤0.015）增加显著相关。排除 37 名 ABI sbp<0.9 或>1.3 的患者后进行亚组分析发现，ABI sbp 和 ABI sbp<0.9 与全因和 CV 死亡率无关。然而，ABImap 和 ABIdbp<0.87 与全因死亡率显著相关（≤0.042）。此外，ABIdbp 和 ABIdbp<0.87 与 CV 死亡率显著相关（≤0.030）。总之，ABI sbp、ABI dbp 和 ABImap 均能预测我们 HD 患者的全因和 CV 死亡率。在 ABI sbp 正常的亚组患者中，ABI sbp 和 ABI sbp<0.9 对全因和 CV 死亡率的预测作用不大。然而，ABImap 和 ABIdbp<0.87 仍可预测全因死亡率，ABIdbp 和 ABIdbp<0.87 可预测 CV 死亡率。因此，使用 DBP 和 MAP 计算 ABI 可能有助于预测 HD 患者的生存情况，尤其是在 ABI sbp 正常的患者中。
