Background
Low ankle-brachial index (ABI) is an established risk factor for long-term cardiovascular
outcomes in patients with acute myocardial infarction (AMI), and brachial-ankle pulse
wave velocity (ba-PWV) may also be a risk factor. However, there is a significant
overlap between low ABI and high ba-PWV. The purpose of this retrospective study was
to examine whether increased ba-PWV was associated with long-term clinical outcomes
in AMI patients with normal ABI.
Methods
We included 932 AMI patients with normal ABI and divided them into the high PWV group
(≥1,400 cm/s; n=646) and the low PWV group (<1400 cm/s; n=286) according to the ba-PWV
values measured during the AMI hospitalisation. The primary endpoint was the major
adverse cardiovascular events (MACE) defined as the composite of all-cause death,
nonfatal myocardial infarction, and hospitalisation for heart failure.
Results
During the median follow-up duration of 541 days (Q1: 215 days–Q3: 1,022 days), a
total of 154 MACE were observed. The Kaplan-Meier curves showed that MACE was more
frequently observed in the high PWV group than in the low PWV group (p<0.001). The
multivariate Cox hazard analysis revealed that high ba-PWV was significantly associated
with MACE (hazard ratio [HR] 1.587; 95% CI 1.002–2.513; p=0.049) after controlling
multiple confounding factors.
Conclusions
High ba-PWV was significantly associated with long-term adverse events in AMI patients
with normal ABI. Our results suggest the usefulness of PWV as a prognostic marker
in AMI with normal ABI.
Keywords
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Article info
Publication history
Published online: July 14, 2022
Accepted:
May 22,
2022
Received in revised form:
May 14,
2022
Received:
February 22,
2022
Identification
Copyright
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
