Evidence map›Paper›PMID 34688158›Full record

ArticleAtherosclerosis2021

Ankle-brachial index and subsequent risk of incident and recurrent cardiovascular events in older adults: The Atherosclerosis Risk in Communities (ARIC) study.

Frances M Wang, Chao Yang, Shoshana H Ballew, Corey A Kalbaugh, Michelle L Meyer, Hirofumi Tanaka, Gerardo Heiss, Matthew Allison, Maya Salameh, Josef Coresh and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Atherosclerosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Review
  8. Article
  9. Assessment of Atherosclerotic Cardiovascular Disease Risk in Primary Prevention.Journal of cardiopulmonary rehabilitation and prevention · 2022
    Review
  10. Article
  11. Article
  12. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Frances M WangJohns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Chao YangJohns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Shoshana H BallewJohns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Corey A KalbaughClemson University, Clemson, SC, USA.
Michelle L MeyerUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Hirofumi TanakaUniversity of Texas at Austin, Austin, TX, USA.
Gerardo HeissUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Matthew AllisonUniversity of California San Diego, San Diego, CA, USA.
Maya SalamehJohns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Josef CoreshJohns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Kunihiro MatsushitaJohns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: kuni.matsushita@jhu.edu.
Johns Hopkins University · USUniversity of North Carolina at Chapel Hill · USClemson University · USThe University of Texas at Austin · USUniversity of California San Diego · US

Funding

ARIC Neurocognitive Study (ARIC-NCS) Renewal 2023-2028U01HL096812 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, THOMAS H MOSLEY · 2010 to 2026
$65.7M
CARDIOVASCULAR EPIDEMIOLOGY INSTITUTIONAL TRAININGT32HL007024 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Elizabeth Selvin · 1985 to 2026
$17.5M
NHLBI NIH HHS HHSN268201700001CNHLBI NIH HHS HHSN268201700001INHLBI NIH HHS HHSN268201700002CNHLBI NIH HHS HHSN268201700002INHLBI NIH HHS HHSN268201700003CNHLBI NIH HHS HHSN268201700003INHLBI NIH HHS HHSN268201700004CNHLBI NIH HHS HHSN268201700004INHLBI NIH HHS HHSN268201700005CNHLBI NIH HHS HHSN268201700005INHLBI NIH HHS T32 HL007024NHLBI NIH HHS U01 HL096812
6 · The paper itself

Abstract

BACKGROUND AND

aimsThe ankle-brachial index (ABI) is a diagnostic test for screening and detecting peripheral artery disease (PAD), as well as a risk enhancer in the AHA/ACC guidelines on the primary prevention of atherosclerotic cardiovascular disease (ASCVD). However, our understanding of the association between ABI and cardiovascular risk in contemporary older populations is limited. Additionally, the prognostic value of ABI among individuals with prior ASCVD is not well understood.

methodsAmong 5,003 older adults at ARIC visit 5 (2011-2013) (4,160 without prior ASCVD [median age 74 years, 38% male], and 843 with ASCVD [median age 76 years, 65% male]), we quantified the association between ABI and the risk of heart failure (HF), and composite coronary heart disease and stroke (CHD/stroke) using multivariable Cox regression models.

resultsOver a median follow-up of 5.5 years, we observed 400 CHD/stroke events and 338 HF cases (242 and 199 cases in those without prior ASCVD, respectively). In participants without a history of ASCVD, a low ABI ≤0.9 (relative to ABI 1.11-1.20) was associated with both CHD/stroke and HF (adjusted hazard ratios 2.40 [95% CI: 1.55-3.71] and 2.23 [1.40-3.56], respectively). In those with prior ASCVD, low ABI was not significantly associated with CHD/stroke, but was with HF (7.12 [2.47-20.50]). The ABI categories of 0.9-1.2 and > 1.3 were also independently associated with increased HF risk. Beyond traditional risk factors, ABI significantly improved the risk discrimination of CHD/stroke in those without ASCVD and HF, regardless of baseline ASCVD.

conclusionsLow ABI was associated with CHD/stroke in those without prior ASCVD and higher risk of HF regardless of baseline ASCVD status. These results support ABI as a risk enhancer for guiding primary cardiovascular prevention and suggest its potential value in HF risk assessment for older adults.

Indexed as

AtherosclerosisCoronary DiseasePeripheral Arterial DiseaseAgedAnkle Brachial IndexFemaleHumansIncidenceMaleRisk AssessmentRisk FactorsAnkle-brachial indexAtherosclerotic cardiovascular diseaseOlder adultsRisk assessment

Identifiers

PMID34688158
PMCPMC8604439
OpenAlexW3204701045

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.