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Ankle-brachial index (ABI), abdominal aortic calcification (AAC), and coronary artery calcification (CAC): the Jackson heart study

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Abstract

To examine the associations of peripheral atherosclerosis, assessed by the ABI at baseline with the extent of AAC and with CAC measured by MDCT at follow-up examination in the Jackson Heart Study cohort. Four categories of ABI: <0.90, 0.90–0.99, 1.00–1.39; >1.40. Presence of CAC/AAC was defined as scoring above the 75th percentile among participants with non-zero CT calcium scores. We conducted multivariable log-binomial models for this analysis examining the relationship between ABI and the presence of CAC or AAC using normal ABI (1.0 ≤ ABI ≤ 1.39) as the reference group. We estimated prevalence ratios adjusted for age, smoking, HTN, DM, BMI, LDL, HDL, CRP, systolic and diastolic blood pressure, and use of lipid-lowering medication. There were 2,398 patients in this analysis (women: 65 %, average age 55 years). AAC scores were not significantly different between sex. CAC scores were significantly higher in males than females regardless of ABI groups. The prevalence of significant AAC was 1.7 times higher for ABI < 0.90 (PR = 1.70; 95 % CI = 1.26–2.28; p = 0.0004) and 1.57 times higher for ABI 0.90–0.99 (PR = 1.57; 95 % CI = 1.20–2.03; p = 0.0008) than the normal ABI; AAC prevalence did not differ between subjects with ABI > 1.40 compared to those with normal ABI. The prevalence of the significant CAC was higher for ABI < 0.90 (PR = 1.55; 95 % CI = 1.12–2.14; p value = 0.0081) and ABI 0.90–0.99 (PR = 1.60; 95 % CI = 1.05–2.46; p = 0.0402) compared to normal ABI; CAC prevalence did not differ between subjects with ABI > 1.40 compared to those with normal ABI. Lower ABI was significantly associated with the extent of AAC and CAC in this cohort. ABI can provide clinicians with an inexpensive additional tool to assess vascular health and cardiovascular risk without exposing the patient to ionizing radiation.

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Acknowledgments

The authors thank the staff and participants in the Jackson Heart Study for important contributions. The JHS was supported by the NIH: National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities (NIMHD) [Contracts N01-HC-95170, N01-HC-95171, and N01-HC-95172]. This study was partially supported by NIMHD grant number U54MD008149, to Dr Jae Eun Lee.

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Authors and Affiliations

  1. University of Mississippi Medical Center, Jackson, MS, USA

    Bobby W. Tullos, Marc E. Mitchell & Herman A. Taylor

  2. School of Public Sciences, Jackson State University, 350 W. Woodrow Wilson, Suite 108, Jackson, MS, 39213, USA

    Jung Hye Sung

  3. University of California, San Diego, CA, USA

    Michael H. Criqui

  4. RTRN Data Coordinating Center, Jackson State University, Jackson, USA

    Jae Eun Lee

Authors
  1. Bobby W. Tullos
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  2. Jung Hye Sung
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  3. Jae Eun Lee
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  4. Michael H. Criqui
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  5. Marc E. Mitchell
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  6. Herman A. Taylor
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Correspondence to Jung Hye Sung.

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Tullos, B.W., Sung, J.H., Lee, J.E. et al. Ankle-brachial index (ABI), abdominal aortic calcification (AAC), and coronary artery calcification (CAC): the Jackson heart study. Int J Cardiovasc Imaging 29, 891–897 (2013). https://doi.org/10.1007/s10554-012-0145-y

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