title: The Ankle-Brachial Index is Associated With Cardiovascular Complications After Noncardiac Surgery.
abstract: BACKGROUND
  This study evaluated the association of the ankle-brachial index (ABI) and cardiovascular complications after noncardiac surgery.
  
  
  METHODS
  We prospectively evaluated patients referred for noncardiac surgery. The ABI was performed before surgery. Patients with abnormal ABI (≤ 0.9) were included in the peripheral artery disease (PAD) group and the remaining constituted the control group. Cardiac troponin and electrocardiogram were obtained 72 hours after surgery. Patients were followed up to 30 days, and primary end point was the occurrence of any cardiovascular event: cardiovascular death, acute coronary syndrome, isolated troponin elevation (ITE), decompensated heart failure, cardiogenic shock, unstable arrhythmias, nonfatal cardiac arrest, pulmonary edema, stroke, or PAD symptoms increase.
  
  
  RESULTS
  We evaluated 124 patients (61.3% male; mean age 65.4 years). During the study, 57.9% of patients in the PAD group had an event versus 25.7% in the control group (P = .011). The ITE was the most observed event (24.2%). After logistic regression, the odds ratio for ITE was 7.4 (95% confidence interval 2.2-25.0, P = .001).
  
  
  CONCLUSIONS
  In patients submitted to noncardiac surgery, abnormal ABI is associated with a higher occurrence of a cardiovascular event.
authors.affiliation: Interdisciplinary Medicine in Cardiology Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, Brazil.
authors.forename: G A
authors.initials: GA
authors.lastname: Carmo
authors.affiliation: Interdisciplinary Medicine in Cardiology Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, Brazil.
authors.forename: D
authors.initials: D
authors.lastname: Calderaro
authors.affiliation: Interdisciplinary Medicine in Cardiology Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, Brazil.
authors.forename: D M
authors.initials: DM
authors.lastname: Gualandro
authors.affiliation: Interdisciplinary Medicine in Cardiology Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, Brazil.
authors.forename: A F
authors.initials: AF
authors.lastname: Pastana
authors.affiliation: Interdisciplinary Medicine in Cardiology Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, Brazil.
authors.forename: P C
authors.initials: PC
authors.lastname: Yu
authors.affiliation: Interdisciplinary Medicine in Cardiology Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, Brazil.
authors.forename: A C
authors.initials: AC
authors.lastname: Marques
authors.affiliation: Interdisciplinary Medicine in Cardiology Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, Brazil bcaramel@usp.br.
authors.forename: B
authors.initials: B
authors.lastname: Caramelli
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014336:Troponin / Q000097:blood; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D014336:Troponin
keywords: ankle-brachial index; atherosclerosis; cardiovascular risk; perioperative care