title: Prognostic value of the ankle-brachial index in patients undergoing drug-eluting stent implantation.
abstract: OBJECTIVE
  Limited data are available regarding the prognostic value of the brachial-ankle index (ABI) in patients with a history of drug-eluting stent (DES) implantation. This study sought to determine the relationship between the ABI and coronary events in patients with DES.
  
  
  METHODS
  A total of 322 patients who underwent both DES implantation and ABI measurement during initial hospitalization were reviewed. Cardiovascular events, including cardiac death, non-fatal acute myocardial infarction and coronary revascularization, were assessed.
  
  
  RESULTS
  During the mean follow-up period of 298 ± 58 days, there were 32 cases of cardiovascular events (9.9%). The patients with a lower ABI had more events (2.8% in the highest tertile versus 10.3% in the middle tertile versus 16.8% in the lowest tertile, p = 0.001). According to the multiple Cox regression analysis, the ABI was independently associated with clinical events (the lowest tertile versus the highest tertile of ABI, hazard ratio: 6.35, 95% confidence interval: 1.37-29.32, p=0.018). In addition, the cumulative event rate according to the ABI tertile differed significantly in the Kaplan-Meier curves (log-rank p=0.009), whereas the receiver-operating characteristic curve analysis showed a sensitivity and specificity for predicting cardiovascular events of 62.5% and 66.2%, respectively, with an ABI of 1.057 as the best cut-off value.
  
  
  CONCLUSIONS
  A lower ABI is associated with poorer cardiovascular outcomes in patients with DES implantation. As a simple and non-invasive parameter, the ABI has the benefit of predicting future cardiovascular events in this population.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul National University College of Medicine.
authors.forename: Hack-Lyoung
authors.initials: HL
authors.lastname: Kim
authors.forename: Jae-Bin
authors.initials: JB
authors.lastname: Seo
authors.forename: Woo-Young
authors.initials: WY
authors.lastname: Chung
authors.forename: Joo-Hee
authors.initials: JH
authors.lastname: Zo
authors.forename: Myung-A
authors.initials: MA
authors.lastname: Kim
authors.forename: Sang-Hyun
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D000843:Ankle Joint / Q000098:blood supply*; D001916:Brachial Artery / Q000502:physiology*; D003324:Coronary Artery Disease / Q000401:mortality* / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate