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Heart failure risk across the spectrum of ankle-brachial index: the ARIC study (Atherosclerosis Risk In Communities).

Publication ,  Journal Article
Gupta, DK; Skali, H; Claggett, B; Kasabov, R; Cheng, S; Shah, AM; Loehr, LR; Heiss, G; Nambi, V; Aguilar, D; Wruck, LM; Matsushita, K ...
Published in: JACC Heart Fail
October 2014

OBJECTIVES: The aim of this study was to describe the relationship between ankle brachial index (ABI) and the risk for heart failure (HF). BACKGROUND: The ABI is a simple, noninvasive measure associated with atherosclerotic cardiovascular disease and death; however, the relationship between ABI and risk for HF is less well characterized. METHODS: Between 1987 and 1989 in the ARIC (Atherosclerosis Risk In Communities) study, an oscillometric device was used to measure blood pressure in a single upper and randomly chosen lower extremity to determine the ABI. Incident HF events were defined by the first hospitalization with an International Classification of Diseases, Ninth Revision, code of 428.x through 2008. The risk for HF was assessed across the ABI range using restricted cubic splines and Cox proportional hazards models. RESULTS: ABI was available in 13,150 participants free from prevalent HF. Over a mean 17.7 years of follow-up, 1,809 incident HF events occurred. After adjustment for traditional HF risk factors, prevalent coronary heart disease, subclinical carotid atherosclerosis, and interim myocardial infarction, compared with an ABI of 1.01 to 1.40, participants with ABIs ≤0.90 were at increased risk for HF (hazard ratio: 1.40; 95% confidence interval: 1.12 to 1.74), as were participants with ABIs of 0.91 to 1.00 (hazard ratio: 1.36; 95% confidence interval: 1.17 to 1.59). CONCLUSIONS: In a middle-age community cohort, an ABI ≤1.00 was significantly associated with an increased risk for HF, independent of traditional HF risk factors, prevalent coronary heart disease, carotid atherosclerosis, and interim myocardial infarction. Low ABI may reflect not only overt atherosclerosis but also pathologic processes in the development of HF beyond epicardial atherosclerotic disease and myocardial infarction alone. A low ABI, as a simple, noninvasive measure, may be a risk marker for HF.

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Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

October 2014

Volume

2

Issue

5

Start / End Page

447 / 454

Location

United States

Related Subject Headings

  • Prospective Studies
  • Proportional Hazards Models
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Female
  • Coronary Artery Disease
  • Cohort Studies
 

Citation

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ICMJE
MLA
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Gupta, D. K., Skali, H., Claggett, B., Kasabov, R., Cheng, S., Shah, A. M., … Solomon, S. D. (2014). Heart failure risk across the spectrum of ankle-brachial index: the ARIC study (Atherosclerosis Risk In Communities). JACC Heart Fail, 2(5), 447–454. https://doi.org/10.1016/j.jchf.2014.05.008
Gupta, Deepak K., Hicham Skali, Brian Claggett, Rumen Kasabov, Susan Cheng, Amil M. Shah, Laura R. Loehr, et al. “Heart failure risk across the spectrum of ankle-brachial index: the ARIC study (Atherosclerosis Risk In Communities).JACC Heart Fail 2, no. 5 (October 2014): 447–54. https://doi.org/10.1016/j.jchf.2014.05.008.
Gupta DK, Skali H, Claggett B, Kasabov R, Cheng S, Shah AM, et al. Heart failure risk across the spectrum of ankle-brachial index: the ARIC study (Atherosclerosis Risk In Communities). JACC Heart Fail. 2014 Oct;2(5):447–54.
Gupta, Deepak K., et al. “Heart failure risk across the spectrum of ankle-brachial index: the ARIC study (Atherosclerosis Risk In Communities).JACC Heart Fail, vol. 2, no. 5, Oct. 2014, pp. 447–54. Pubmed, doi:10.1016/j.jchf.2014.05.008.
Gupta DK, Skali H, Claggett B, Kasabov R, Cheng S, Shah AM, Loehr LR, Heiss G, Nambi V, Aguilar D, Wruck LM, Matsushita K, Folsom AR, Rosamond WD, Solomon SD. Heart failure risk across the spectrum of ankle-brachial index: the ARIC study (Atherosclerosis Risk In Communities). JACC Heart Fail. 2014 Oct;2(5):447–454.
Journal cover image

Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

October 2014

Volume

2

Issue

5

Start / End Page

447 / 454

Location

United States

Related Subject Headings

  • Prospective Studies
  • Proportional Hazards Models
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Female
  • Coronary Artery Disease
  • Cohort Studies