PS 11-15 HIGH ANKLE-BRACHIAL INDEX (ABI) REFLECTS INCREASED TRADITIONAL CARDIOVASCULAR RISK FACTORS, BUT LOW ABI IS ASSOCIATED WITH VASCULAR CALCIFICATION IN PATIENTS WITH CHRONIC KIDNEY DISEASE

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Abstract

Objective:

Ankle-brachial index (ABI) is a method for predicting vascular dysfunction. Previous reports demonstrated the proportion of high (≥1.3) as well as low (≤0.9) ABI increases as decreasing estimated glomerular filtration rate (eGFR) and abnormal ABI is associated with cardiovascular (CV) risks in CKD population. The aim of this study was to investigate the association between ABI and CV risks in patients with CKD.

Design and Method:

Data was recruited from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD), a prospective cohort study, enrolls subjects with CKD (predialysis). The patients were divided into three groups according to ABI; low (≤0.9), high (≥1.3), or normal ABI group. Multiple logistic regression analysis was used to identify the association between abnormal ABI and CV risks.

Results:

A total of 1,818 patients were enrolled. The mean age was 53.5 ± 12.3 years. Abnormal ABI group showed significantly older age (low vs normal vs high: 58.5 ± 11.9 vs 52.7 ± 12.3 vs 59.5 ± 9.6 years, P < 0.001), more male (71.4 vs 59.7 vs 77.4%, P < 0.001), prevalent diabetes (53.6 vs 29.0 vs 48.8%, P < 0.001), higher left ventricular mass index (LVMI) (104 ± 30 vs 93 ± 25 vs 106 ± 25 g/m3, P < 0.001), and log coronary calcium score (logCCS) (4.8 ± 2.0 vs 3.4 ± 1.6 vs 4.3 ± 1.8, P < 0.001), while eGFR was significantly lower in abnormal ABI group (41.8 ± 24.1 vs 51.2 ± 30.3 vs 41.1 ± 26.3 ml/min/1.73m2, P < 0.001). In multiple logistic regression, older (odds ratio [OR], 1.060; 95% confidence interval [CI], 1.029–1.091, P < 0.001), male (OR, 4.731; 95% CI, 2.169–10.317, P < 0.001), smoking (OR, 0.502; 95% CI, 0.267–0.945, P = 0.033), and LVMI (OR, 1.016; 95% CI, 1.005–1.028, P = 0.005) were associated with higher ABI group, while logCCS (OR, 1.313; 95% CI, 1.082–1.592, P = 0.006) was independently associated with low ABI group.

Conclusions:

Abnormal ABI is associated with CV risks in patients with CKD. However, present study suggests that high and low ABI might have substantial difference from pathophysiological mechanisms in CKD patients.

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