Impact of chronic kidney disease on the association of high ankle-brachial index with cardiovascular mortality and all-cause mortality.

IF 2.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Acta cardiologica Pub Date : 2025-09-01 Epub Date: 2025-08-05 DOI:10.1080/00015385.2025.2538405

Huan Jin, Tianbo Wang

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引用次数: 0

Abstract

Objectives: This study aims to investigate the impact of chronic kidney disease (CKD) on the association of ankle-brachial index (ABI) with long-term cardiovascular and all-cause mortality.

Methods: This cohort study utilised the data from the National Health and Nutrition Examination Survey (NHANES), with mortality follow-up tracked through the National Death Index until December 31, 2019. CKD was defined by an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m² and/or a urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g. ABI categories were defined as ≤0.9 (low), 0.9-1.4 (normal), and >1.4 (high). Cox proportional hazards models were employed to evaluate the association of ABI with long-term cardiovascular and all-cause mortality in individuals with or without CKD.

Results: A total of 6,318 individuals were included, with 1,311 (20.8%) having CKD. The median follow-up duration was 203 (IQR: 183-223) months. After adjustments, compared to those with normal ABI, high ABI was associated with increased cardiovascular and all-cause mortality in individuals with CKD (hazard ratio [HR] 3.64, 95% CI 1.30-10.23 for cardiovascular mortality; HR 2.10, 95% CI 1.14-3.89 for all-cause mortality) but not in those without CKD. Low ABI was associated with an increased risk of cardiovascular and all-cause mortality in both CKD (HR 1.95, 95% CI 1.31-2.92 and HR 1.49, 95% CI 1.13-1.97, respectively) and non-CKD individuals (HR 1.90, 95% CI 1.27-2.82 and HR 1.60, 95% CI 1.32-1.94, respectively).

Conclusions: High ABI was associated with increased cardiovascular and all-cause mortality in patients with CKD, but not in those without CKD.

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慢性肾脏疾病对高踝肱指数与心血管死亡率和全因死亡率之间关系的影响

目的：本研究旨在探讨慢性肾脏疾病（CKD）对踝肱指数（ABI）与长期心血管和全因死亡率的相关性的影响。方法：本队列研究利用了国家健康与营养检查调查（NHANES）的数据，并通过国家死亡指数对死亡率进行了随访，直至2019年12月31日。CKD的定义是肾小球滤过率（eGFR） 2和/或尿白蛋白与肌酐比值(UACR)≥30mg /g。ABI分类定义为≤0.9（低）、0.9-1.4（正常）和>1.4（高）。采用Cox比例风险模型评估ABI与有或无CKD个体的长期心血管和全因死亡率的关系。结果：共纳入6318人，其中1311人（20.8%）患有CKD。中位随访时间为203 （IQR: 183-223）个月。调整后，与ABI正常的患者相比，高ABI与CKD患者心血管和全因死亡率增加相关(心血管死亡率的危险比[HR] 3.64, 95% CI 1.30-10.23；全因死亡率的HR为2.10,95% CI为1.14-3.89)，但在无CKD的患者中没有。低ABI与CKD （HR 1.95, 95% CI 1.31-2.92, HR 1.49, 95% CI 1.13-1.97）和非CKD个体（HR 1.90, 95% CI 1.27-2.82, HR 1.60, 95% CI 1.32-1.94）的心血管和全因死亡风险增加相关。结论：高ABI与CKD患者心血管和全因死亡率增加有关，但与非CKD患者无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta cardiologica 医学-心血管系统

CiteScore

2.50

自引率

12.50%

发文量

115

审稿时长

2 months

期刊介绍： Acta Cardiologica is an international journal. It publishes bi-monthly original, peer-reviewed articles on all aspects of cardiovascular disease including observational studies, clinical trials, experimental investigations with clear clinical relevance and tutorials.