Inclusion of ABI May Better Detect Vascular Disease
(HealthDay News) – Inclusion of the ankle/brachial index (ABI) may better identify vascular disease in patients with non-valvular atrial fibrillation (NVAF), according to a study published online Aug. 14 in the Journal of the American College of Cardiology.
Francesco Violi, MD, from the Sapienza University Of Rome, and colleagues enrolled consecutive adult patients with NVAF referred to internal medicine wards (October 2010–October 2012) who had ABI measurements. Patients with acquired or congenital valvular AF, active cancer, disease with life expectancy <3 years, hyperthyroidism, and pregnancy were excluded.
The researchers found that, of the 2,027 NVAF patients included in the study, 83% had hypertension, 23% had diabetes mellitus, 39% had dyslipidemia, 29% had metabolic syndrome, and 15% smoked. Additionally, at least one atherosclerotic risk factor was detected in 90% of patients. Despite being at high risk for stroke, 16% were untreated with any antithrombotic drug, 19% were treated with antiplatelet drugs, 61% were treated with oral anticoagulants, and 4% were treated with both antiplatelet drugs and oral anticoagulants. Just over one-fifth (21%) had ABI ≤0.9, indicating that NVAF is often associated with systemic atherosclerosis. Inclusion of ABI ≤0.9 in the CHA2DS2-VASc score allowed for better identification of the risk profile, with an up-grading of the risk score in each score category.
"This study provides the first evidence that one-fifth of NVAF patients had an ABI ≤0.9, indicating that it may represent a simple and cheap method to better define the prevalence of vascular disease in NVAF," the authors write.
One author disclosed financial ties to the pharmaceutical industry.