Su Yi-Jia, Wang Szu-Han, Chen Po-Wei, Chao Ting-Hsing, Chang Hsien-Yuan
Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Dou-Liu Branch, College of Medicine, National Cheng Kung University, Yun-Lin.
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University.
Acta Cardiol Sin. 2025 Sep;41(5):656-665. doi: 10.6515/ACS.202509_41(5).20250515A.
The resting ankle-brachial index (ABI) is widely used to diagnose lower extremity artery disease (LEAD). However, some LEAD patients have a normal ABI yet require percutaneous transluminal angioplasty (PTA).
This was a retrospective study of consecutive LEAD patients who underwent PTA. The patients were classified into two groups based on the ABI of the limb that underwent PTA: the ABI-normal group (ABI 0.91-1.40), and ABI-abnormal group (ABI ≤ 0.90 or > 1.40). The primary endpoints were major adverse cardiovascular and cerebral events (MACCEs) and major adverse limb events (MALEs).
Of the 334 patients (mean age: 70 ± 12 years, 60% male), 69 (21%) had a normal ABI, and 265 (79%) had an abnormal ABI. After a median follow-up of 1.5 (0.6-3.1) years, 84 (25%) patients reached the primary or secondary endpoints. The ABI-normal group had a higher proportion of males (73% vs. 57%, p = 0.02) and a higher prevalence of chronic kidney disease (78% vs. 56%, p < 0.01). Angiography revealed less severe lesions in the femoropopliteal artery (p < 0.01) and a lower rate of stent deployment (15% vs. 31%, p < 0.01) in the ABI-normal group than in the ABI-abnormal group. However, the incidence rates of MACCEs (29% vs. 24%, p = 0.56) and MALEs (23% vs. 28%, p = 0.63) were comparable in the two groups.
LEAD patients with a normal ABI often have less severe above-the-knee artery lesions but similar poor outcomes, highlighting the need for additional hemodynamic assessments and increased clinical attention.
静息踝肱指数（ABI）广泛用于诊断下肢动脉疾病（LEAD）。然而，一些LEAD患者的ABI正常，但仍需要接受经皮腔内血管成形术（PTA）。
这是一项对连续接受PTA的LEAD患者的回顾性研究。根据接受PTA肢体的ABI将患者分为两组：ABI正常组（ABI 0.91 - 1.40）和ABI异常组（ABI≤0.90或>1.40）。主要终点是主要不良心血管和脑血管事件（MACCEs）以及主要不良肢体事件（MALEs）。
在334例患者（平均年龄：70±12岁，60%为男性）中，69例（21%）ABI正常，265例（79%）ABI异常。中位随访1.5（0.6 - 3.1）年后，84例（25%）患者达到主要或次要终点。ABI正常组男性比例更高（73%对57%，p = 0.02），慢性肾病患病率更高（78%对56%，p < 0.01）。血管造影显示，ABI正常组股腘动脉病变较轻（p < 0.01），支架置入率较低（15%对31%，p < 0.01）。然而，两组的MACCEs发生率（29%对24%，p = 0.56）和MALEs发生率（23%对28%，p = 0.63）相当。
ABI正常的LEAD患者膝上动脉病变通常较轻，但预后相似，这凸显了进行额外血流动力学评估和加强临床关注的必要性。
