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Ankle-Brachial Index and Risk of Sudden Cardiac Death in the Community: The ARIC Study

Title: Ankle-Brachial Index and Risk of Sudden Cardiac Death in the Community: The ARIC Study
Authors: Suzuki, Takeki; Zhu, Xiaoqian; Adabag, Selcuk; Matsushita, Kunihiro; Butler, Kenneth R.; Griswold, Michael E.; Alonso, Alvaro; Rosamond, Wayne; Sotoodehnia, Nona; Mosley, Thomas H.
Contributors: Medicine, School of Medicine
Source: PMC
Publisher Information: American Heart Association
Publication Year: 2024
Collection: Indiana University - Purdue University Indianapolis: IUPUI Scholar Works
Subject Terms: Ankle–brachial index; Epidemiology; Subclinical atherosclerosis; Sudden cardiac death
Description: Background: Sudden cardiac death (SCD) is a significant global public health problem accounting for 15% to 20% of all deaths. A great majority of SCD is associated with coronary heart disease, which may first be detected at autopsy. The ankle-brachial index (ABI) is a simple, noninvasive measure of subclinical atherosclerosis. The purpose of this study was to examine the relationship between ABI and SCD in a middle-aged biracial general population. Methods and results: Participants of the ARIC (Atherosclerosis Risk in Communities) study with an ABI measurement between 1987 and 1989 were included. ABI was categorized as low (≤0.90), borderline (0.90-1.00), normal (1.00-1.40), and noncompressible (>1.40). SCD was defined as a sudden pulseless condition presumed to be caused by a ventricular tachyarrhythmia in a previously stable individual and was adjudicated by a committee of cardiac electrophysiologists, cardiologists, and internists. Cox proportional hazards models were used to evaluate the associations between baseline ABI and incident SCD. Of the 15 081 participants followed for a median of 23.5 years, 556 (3.7%) developed SCD (1.96 cases per 1000 person-years). Low and borderline ABIs were associated with an increased risk of SCD (demographically adjusted hazard ratios [ HRs ], 2.27 [ 95% CI, 1.64-3.14 ] and 1.52 [ 95% CI, 1.17-1.96 ], respectively) compared with normal ABI. The association between low ABI and SCD remained significant after adjustment for traditional cardiovascular risk factors (HR, 1.63 [ 95% CI, 1.15-2.32 ]). Conclusions: Low ABI is independently associated with an increased risk of SCD in a middle-aged biracial general population. ABI could be incorporated into future SCD risk prediction models.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: Journal of the American Heart Association; https://hdl.handle.net/1805/42107
Availability: https://hdl.handle.net/1805/42107
Rights: Attribution-NonCommercial-NoDerivatives 4.0 International ; http://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.4A9B7F56
Database: BASE