Influence of an abnormal ankle-brachial index on ischemic and bleeding events in patients undergoing percutaneous coronary intervention
- Author:
Hangyul KIM
1
;
Seung Do LEE
;
Hyo Jin LEE
;
Hye Ree KIM
;
Kyehwan KIM
;
Jin-Sin KOH
;
Seok-Jae HWANG
;
Jin-Yong HWANG
;
Jong-Hwa AHN
;
Yongwhi PARK
;
Young-Hoon JEONG
;
Jeong Rang PARK
;
Min Gyu KANG
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2023;38(3):372-381
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:Bleeding events after percutaneous coronary intervention (PCI) have important prognostic implications. Data on the influence of an abnormal ankle-brachial index (ABI) on both ischemic and bleeding events in patients undergoing PCI are limited.
Methods:We included patients who underwent PCI with available ABI data (abnormal ABI, ≤ 0.9 or > 1.4). The primary endpoint was the composite of all-cause death, myocardial infarction (MI), stroke, and major bleeding.
Results:Among 4,747 patients, an abnormal ABI was observed in 610 patients (12.9%). During follow-up (median, 31 months), the 5-year cumulative incidence of adverse clinical events was higher in the abnormal ABI group than in the normal ABI group: primary endpoint (36.0% vs. 14.5%, log-rank test, p < 0.001); all-cause death (19.4% vs. 5.1%, log-rank test, p < 0.001); MI (6.3% vs. 4.1%, log-rank test, p = 0.013); stroke (6.2% vs. 2.7%, log-rank test, p = 0.001); and major bleeding (8.9% vs. 3.7%, log-rank test, p < 0.001). An abnormal ABI was an independent risk factor for all-cause death (hazard ratio [HR], 3.05; p < 0.001), stroke (HR, 1.79; p = 0.042), and major bleeding (HR, 1.61; p = 0.034).
Conclusions:An abnormal ABI is a risk factor for both ischemic and bleeding events after PCI. Our study findings may be helpful in determining the optimal method for secondary prevention after PCI.