Predictive value of ankle-brachial index and blood glucose on the outcomes of six-year all-cause mortality and cardiovascular mortality in a Chinese population of type 2 diabetes patients

Y Wang, Q Mou, D Zhao, Y Xu, D Hu, H Ma, J Liu, X Guo, J Li
International Angiology: a Journal of the International Union of Angiology 2012, 31 (6): 586-94

AIM: The aim of this paper was to investigate the predictive value of ankle-brachial index (ABI) and blood glucose to estimate mortality in Chinese type 2 diabetes patients.

METHODS: Chinese type 2 diabetes patients (1706 subjects) were followed up for about 6 years,

RESULTS: One thousand four hundred fourteen were included in the final statistical analysis during a median follow-up of 69 months. Overall, 398 patients died during follow-up and 254 deaths were attributable to cardiovascular disease (CVD). Relative risks of all-cause and CVD mortality of patients with ABI≤0.4 were increased by 2.073-fold (95% CI: 1.236-3.478) and 3.086-fold (95% CI: 1.702-5.595), compared with those of patients with ABI>1.0 and ≤1.4. Mortality was significantly increased with increasing plasma glucose and decreasing ABI. All-cause and CVD mortality was the highest (55.6% and 44.4%) with ABI≤0.4 and plasma glucose >10 mmol/L simultaneously. Relative risks of all-cause and CVD mortality in these patients were increased by 3.905-fold (95% CI: 1.334-11.431) and 3.771-fold (95% CI: 1.079-13.171), compared with patients with ABI>1.0 and ≤1.4, and plasma glucose ≤6 mmol/L simultaneously. Models to evaluate additional predictive value of ABI for mortality of type 2 diabetes patients suggested that addition of ABI significantly improved the prediction of the death rate compared with the model including conventional risk factors only.

CONCLUSION: High plasma glucose and low ABI had synergistic effects on increasing mortality of type 2 diabetes patients. The addition of ABI can significantly improve the prediction of mortality compared to protocol using conventional risk factors only.

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