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KMID : 0338420230380030372
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The Korean Journal of Internal Medicine
2023 Volume.38 No. 3 p.372 ~ p.381
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Influence of an abnormal ankle-brachial index on ischemic and bleeding events in patients undergoing percutaneous coronary intervention
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Kim Han-Gyul
Lee Seung-Do
Lee Hyo-Jin
Kim Hye-Ree
Kim Kye-Hwan
Koh Jin-Sin
Hwang Seok-Jae
Hwang Jin-Yong
Ahn Jong-Hwa
Park Yong-Whi
Jeong Young-Hoon
Park Jeong-Rang
Kang Min-Gyu
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Abstract
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Background/Aims: Bleeding events after percutaneous coronary intervention (PCI) have important prognostic implications.
Data on the influence of an abnormal ankle-brachial index (ABI) on both ischemic and bleeding events in patients undergoing PCI are limited.
Methods: We included patients who underwent PCI with available ABI data (abnormal ABI, ≤ 0.9 or > 1.4). The primary endpoint was the composite of all-cause death, myocardial infarction (MI), stroke, and major bleeding.
Results: Among 4,747 patients, an abnormal ABI was observed in 610 patients (12.9%). During follow-up (median, 31 months), the 5-year cumulative incidence of adverse clinical events was higher in the abnormal ABI group than in the normal ABI group: primary endpoint (36.0% vs. 14.5%, log-rank test, p < 0.001); all-cause death (19.4% vs. 5.1%, log-rank test, p < 0.001); MI (6.3% vs. 4.1%, log-rank test, p = 0.013); stroke (6.2% vs. 2.7%, log-rank test, p = 0.001); and major bleeding (8.9% vs. 3.7%, log-rank test, p < 0.001). An abnormal ABI was an independent risk factor for all-cause death (hazard ratio [HR], 3.05; p < 0.001), stroke (HR, 1.79; p = 0.042), and major bleeding (HR, 1.61; p = 0.034).
Conclusions: An abnormal ABI is a risk factor for both ischemic and bleeding events after PCI. Our study findings may be helpful in determining the optimal method for secondary prevention after PCI.
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KEYWORD
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Percutaneous coronary intervention, Ankle-brachial index, Peripheral artery disease, Ischemic event, Bleeding event
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