title: Prognostic value of ankle brachial index for future incident heart failure in patients without previous heart failure: data from the impressive predictive value of ankle brachial index for clinical long term outcome in patients with cardiovascular disease examined by ABI study.
abstract: The ankle brachial index (ABI) is regarded as a predictor of future cardiovascular events. However, the relationship between ABI and incident heart failure (HF) in patients without previous HF is poorly understood. This study aimed to assess the prognostic value of ABI for incident HF in patients without previous HF. The IMPACT-ABI study was a retrospective, single-center, cohort study that enrolled and measured ABI in 3131 patients hospitalized for cardiovascular disease between January 2005 and December 2012. From this cohort, 307 patients were excluded because of previous HF and high (>1.4) ABI. The remaining 2824 patients were stratified into three groups: low ABI (≤0.9), borderline ABI (0.91-0.99), and normal ABI (1.0-1.4). The primary endpoint was hospitalization for HF. Over a mean 4.8-year follow-up, 105 cases of HF occurred. The cumulative incidence of HF was significantly higher in patients with low and borderline ABIs than in those with normal ABI (19.3 vs. 21.0 vs. 10.4 %, log rank P <0.001). In multivariate Cox proportional hazard analysis, low ABI and borderline ABI were independent predictors of incident HF [hazard ratio (HR) 3.00; 95 % confidence interval (CI) 1.70-5.28; P < 0.001 and HR 2.68; 95 % CI 1.35-5.34; P = 0.005, respectively]. In conclusion, low and borderline ABI were strong predictors for future incident HF in patients without previous HF.
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan. hitoshi110@shinshu-u.ac.jp.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nishimura
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Miura
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Minamisawa
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ueki
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Abe
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Hashizume
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Mochidome
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Mikiko
authors.initials: M
authors.lastname: Harada
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Shoin
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshie
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Oguchi
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ebisawa
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Motoki
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Izawa
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Koyama
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan.
authors.forename: Uichi
authors.initials: U
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
keywords: Ankle brachial index; Heart failure; Heart failure with preserved ejection fraction; Peripheral artery disease