title: Superficial femoral artery plaque, the ankle-brachial index, and leg symptoms in peripheral arterial disease: the walking and leg circulation study (WALCS) III.
abstract: BACKGROUND
  The clinical significance of magnetic resonance-imaged plaque characteristics in the superficial femoral artery (SFA) is not well established. We studied associations of the ankle-brachial index (ABI) and leg symptoms with MRI-measured plaque area and percent lumen area in the SFA in participants with and without lower-extremity peripheral arterial disease (PAD).
  
  
  RESULTS
  Four hundred twenty-seven participants (393 with PAD) underwent plaque imaging of the first 30 mm of the SFA. Twelve 2.5-mm cross-sectional images of the SFA were obtained. Outcomes were normalized plaque area, adjusted for artery size (0 to 1 scale, 1=greatest plaque), and lumen area, expressed as a percent of the total artery area. Adjusting for age, sex, race, smoking, statins, cholesterol, and other covariates, lower ABI values were associated with higher normalized mean plaque area (ABI <0.50:0.79; ABI 0.50 to 0.69:0.73; ABI 0.70 to 0.89:0.65; ABI 0.90 to 0.99:0.62; ABI 1.00 to 1.09:0.48; ABI 1.10 to 1.30:0.47 (P trend <0.001)) and smaller mean percent lumen area (P trend <0.001). Compared with PAD participants with intermittent claudication, asymptomatic PAD participants had lower normalized mean plaque area (0.72 versus 0.65, P=0.005) and larger mean percent lumen area (0.30 versus 0.36, P=0.01), adjusting for the ABI and other confounders.
  
  
  CONCLUSIONS
  Lower ABI values are associated with greater MRI-measured plaque burden and smaller lumen area in the first 30 mm of the SFA. Compared with PAD participants with claudication, asymptomatic PAD participants have smaller plaque area and larger lumen area in the SFA. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00520312.
authors: Department of Medicine, Northwestern University’s Feinberg School of Medicine, Chicago, IL, USA. mdm608@northwestern.edu
authors: Mary M
authors: MM
authors: McDermott
authors: Kiang
authors: K
authors: Liu
authors: James
authors: J
authors: Carr
authors: Michael H
authors: MH
authors: Criqui
authors: Lu
authors: L
authors: Tian
authors: Debiao
authors: D
authors: Li
authors: Luigi
authors: L
authors: Ferrucci
authors: Jack M
authors: JM
authors: Guralnik
authors: Christopher M
authors: CM
authors: Kramer
authors: Chun
authors: C
authors: Yuan
authors: Melina
authors: M
authors: Kibbe
authors: William H
authors: WH
authors: Pearce
authors: Jarett
authors: J
authors: Berry
authors: Walter
authors: W
authors: McCarthy
authors: Yihua
authors: Y
authors: Liao
authors: Dongxiang
authors: D
authors: Xu
authors: Jennifer
authors: J
authors: Orozco
authors: Timothy J
authors: TJ
authors: Carroll
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008074:Lipoproteins / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D016138:Walking
chemical_list: D008074:Lipoproteins