Drug-Eluting Stents With Abnormal ABI Tied to Mortality

Predictive of one-year all cause, cardiovascular mortality after drug-eluting stent implantation

THURSDAY, Oct. 20 (HealthDay News) -- For patients undergoing drug-eluting stent (DES) implantation, an abnormal ankle brachial index (ABI) is independently associated with one-year risk of total mortality and cardiovascular mortality, but not with risk of stroke, nonfatal acute coronary syndrome (ACS), or newer revascularization, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

Aida Ribera, Ph.D., from the Red de Enfermedades Cardiovasculares in Barcelona, Spain, and colleagues investigated whether an abnormal ABI value (≤0.9 and ≥1.4) was associated with one-year risk of cardiovascular events after DES implantation. A standardized ABI calculation by Doppler in 1,437 patients who underwent the procedure from January to April 2008 identified 582 patients (40.5 percent of participants) with abnormal ABI. Participants were followed up for 12 months after the DES implantation to determine total and cardiovascular mortality, stroke, nonfatal ACS, and new revascularizations. Conventional logistic regression and propensity-score analysis were used to assess the correlation of an abnormal ABI value with the outcomes.

The investigators found that, compared to patients with normal ABI values, those with abnormal ABI values had higher global cardiovascular risk, and a significantly higher rate of complications during admission (11.3 versus 5.3 percent), with ACS more often being the reason for DES implantation. An abnormal ABI value correlated independently with one-year total mortality and cardiovascular mortality (odds ratios, 2.23 and 2.06, respectively). An abnormal ABI value did not independently correlate with one-year nonfatal ACS, stroke, or new revascularizations.

"Although an abnormal ABI value was associated with fatal outcomes in patients receiving DESs, no association was found with nonfatal ACS and new revascularizations," the authors write.

The study was partially funded by Bristol-Myers-Squibb.

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