Ohkuma T, et al. - Whether ankle–brachial index (ABI) measured with oscillometry relates to the risk of cardiovascular disease (CVD) and premature death in general Asian populations was investigated. In the Japanese population, a significant association of lower and higher ABI with an increased risk of CVD and all-cause mortality was demonstrated. High-risk populations can be detected via incorporation of ABI, which is easily measured by oscillometry, into daily clinical practice.

Methods

• In this individual participant data meta-analysis, a total of 10,679 community-dwelling Japanese individuals with no history of CVD were included.
• A composite of CVD events and all-cause mortality was the primary outcome.

Results

• The primary outcome was experienced by 720 participants over an average of 7.8 years of follow-up.
• With a lower ABI, a significant increase was noted in the multivariable-adjusted hazard ratios (HRs) of the primary outcome.
• Researchers found that the HRs were 1.07 (95% confidence interval [CI] 0.91–1.27) for ABI of 1.00–1.09, HR 1.37 (95% CI 1.04–1.81) for ABI of 0.91–0.99, and HR 1.60 (95% CI 1.06–2.41) for ABI of ≤0.90, compared with ABI of 1.10–1.19.
• They also observed an association of a high ABI (≥1.30) with a greater risk of outcome (HR 2.42 [95% CI 1.14–5.13]).
• They noted similar tendencies for CVD events alone and all-cause mortality alone.
• Addition of ABI to a model with the Framingham risk score marginally improved the c-statistics (p=0.08) and integrated discrimination improvement (p < 0.05) for the primary outcome.