Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland.
University Hospital in Krakow, Krakow, Poland.
Heart Vessels. 2022 Apr;37(4):665-672. doi: 10.1007/s00380-021-01949-1. Epub 2021 Oct 13.
To assess the relationship between ankle-brachial index (ABI) and up to 10-year mortality in older individuals below and above the age of 80 years. In a multicenter survey of health status in the community dwelling subjects aged 55-59 and 65 + years in Poland, we assessed baseline medical history including risk-factors. We measured ABI, and serum creatinine, cholesterol, NT-proBNP, and interleukin-6 (IL-6) concentrations. We assessed mortality based on public registry. Between 2009 and 2019, 27.3% of 561 participants < 80 years, and 79.4% of 291 participants ≥ 80 years, died (p < 0.001); 67.8, 41.5, and 40.3% in the ABI groups < 0.9, 0.9-1.4, and > 1.4, respectively (p < 0.01). In the unadjusted Cox models, ABI was associated with mortality in the entire group, and < 80 years. In the entire group, analysis adjusted for age and sex showed mortality risk increased by 11% per year, and 50% with male sex. Mortality decreased by 37% per 1 unit ABI increase. In the group of people ≥ 80 years, only age was significantly associated with mortality (p < 0.001). In stepwise regression ABI < 0.9, male sex, active smoking, and NT-proBNP level were associated with risk of death < 80 years. In the ≥ 80 years old, mortality risk was associated with older age, and higher levels of IL-6, but not ABI. The ABI < 0.9 is associated with higher mortality in older people, but not among the oldest-old. In the oldest age group, age is the strongest predictor of death. In this age group, inflammageing is of importance.
评估踝臂指数（ABI）与 80 岁以下和 80 岁以上老年人 10 年死亡率之间的关系。在波兰对 55-59 岁和 65 岁及以上社区居民健康状况的多中心调查中，我们评估了包括危险因素在内的基线病史。我们测量了 ABI 以及血清肌酐、胆固醇、NT-proBNP 和白细胞介素 6（IL-6）浓度。我们根据公共登记处评估死亡率。2009 年至 2019 年，561 名<80 岁的参与者中有 27.3%（p<0.001）死亡，291 名≥80 岁的参与者中有 79.4%死亡；ABI<0.9、0.9-1.4 和>1.4 组的死亡率分别为 67.8%、41.5%和 40.3%（p<0.01）。在未调整的 Cox 模型中，ABI 与整个组和<80 岁的死亡率相关。在整个组中，调整年龄和性别后的分析表明，死亡率每年增加 11%，男性增加 50%。ABI 每增加 1 个单位，死亡率降低 37%。在≥80 岁的人群中，只有年龄与死亡率显著相关（p<0.001）。逐步回归显示，ABI<0.9、男性、主动吸烟和 NT-proBNP 水平与<80 岁人群的死亡风险相关。在≥80 岁的人群中，死亡率风险与年龄较大以及更高水平的 IL-6 相关，但与 ABI 无关。ABI<0.9 与老年人死亡率较高相关，但与最年长的老年人无关。在最年长的年龄组中，年龄是死亡的最强预测因素。在该年龄组中，炎症衰老很重要。
