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SIR: Ankle-Brachial Index May Help Predict Cardiac Risk

Endovascular repair for abdominal aortic aneurysms should be first-line treatment

TUESDAY, Mar. 10 (HealthDay News) -- Screening for novel risk factors such as ankle-brachial index (ABI) -- which identifies peripheral arterial disease -- could help prevent the 25 percent of all heart attacks or sudden cardiac deaths that occur in patients thought to be at low risk. In addition, low re-intervention rates associated with endovascular repair for abdominal aortic aneurysms -- comparable to those reported for open surgical repair -- suggest that the minimally invasive procedure can be recommended as a first-line treatment, according to two studies presented at the Society of Interventional Radiology's annual meeting held Mar. 7 to 12 in San Diego.

In one study, Rajoo Dhangana, M.D., and Timothy P. Murphy, M.D., of Rhode Island Hospital in Providence, and colleagues analyzed data on 6,292 subjects from the 1999-2004 National Health and Nutrition Examination Survey. Among subjects with a Framingham Risk score of less than 20 percent, they found that 44.7 percent had at least one of the three conditions -- abnormal ABI, fibrinogen or C-reactive protein -- that are associated with an increased risk of cardiovascular events.

In a second study, Konstantinos Katsanos, M.D., and Tarun Sabharwal, M.D., of Guy's and St. Thomas' Hospital in London, U.K., and colleagues studied 453 patients who underwent endovascular repair for abdominal aortic aneurysms, and found that only 33 (7.2 percent) required secondary interventions, of which only six (1.3 percent) were identified during routine surveillance.

"These simple tests -- like ABI screening -- have the potential to improve the accuracy of cardiovascular risk prediction and thereby have significant public health impact by helping identify people for intensive medical therapy and preventing heart attacks and strokes," Murphy said in a statement.

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