Ankle Brachial Test Improves On Farmingham Assessment
A study published in the Journal of the American Medical Association indicates that assessment of ankle brachial index (ABI) improve evaluation of cardiovascular risk. In fact, findings with such may provide more accurate assessment than is obtained with the Framingham risk score.
Researchers from the University of Edinburgh examined the amount of information derived from ABI. The team sought to determine the value of this data with respect to cardiovascular risk, including prediction of mortality.
The researchers evaluated data collected in both the MEDLINE database from between 1950 and February 2008 and EMBASE between 1980 and February 2008. Studies that included a general population and measurement of baseline ABI were included. Those patients were also followed to determine cardiovascular and total mortality.
Sixteen different patient cohorts were included. A combined data set was created for completion of a meta-analysis. None of the participants had a history of coronary heart disease.
Study findings indicated that patients with low ABI (<0.90) had twice the risk of cardiovascular and total mortality over ten years compared to those patients with the average rate. Those patients additionally had a higher risk of major coronary events.
The research team concluded that ABI is an effective method to assess cardiovascular risk, potentially providing more information than is available with the Framingham risk score (FRS). In fact, it appears that the test can independently predict cardiovascular risk.
If the FRS is modified to included ABI, risk categories would require modification. It would also affect treatment decisions for almost 20 percent of men and 36 percent of women. The researchers recommend that ABI be incorporated in any cardiovascular assessment.
July 11, 2008 Related topics: Diagnostic, Cardiology