European Heart Journal Advance Access originally published online on November 8, 2005
European Heart Journal 2006 27(3):316-322; doi:10.1093/eurheartj/ehi644
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Ankle brachial index, C-reactive protein, and central augmentation index to identify individuals with severe atherosclerosis
1Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark
2The Copenhagen City Heart Study, Bispebjerg University Hospital, Herlev, Denmark
3Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
4Department of Clinical Biochemistry, Herlev University Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark
Received 26 April 2005; revised 16 October 2005; accepted 20 October 2005; online publish-ahead-of-print 8 November 2005.
* Corresponding author. Tel: +45 4488 3297; fax: +45 4488 3311. E-mail address: brno{at}herlevhosp.kbhamt.dk
Objectives We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease.
Methods and results We examined 4159 randomly sampled individuals from the Danish general population, of which 250 had severe atherosclerosis. After adjustment for gender and age, individuals with ankle brachial index of 0.71–0.90 and <0.70 vs. 0.91–1.10 had odds ratios for severe atherosclerosis of 1.6 (95%CI:1.1–2.3) and 2.9 (1.9–4.6), respectively. C-reactive protein of >3.0 or 1.0–3.0 mg/L vs. <1.0 mg/L as well as central augmentation index in quintiles did not identify individuals with severe atherosclerosis, and did not improve further the ability of ankle brachial index to identify such individuals. On a continuous scale using receiver operating characteristics curves, presence of severe atherosclerosis was predicted by ankle brachial index (P=0.00000003), C-reactive protein (P=0.000003), as well as central augmentation index (P=0.001); these three curves did not differ.
Conclusion Ankle brachial index <0.9 identify individuals with severe atherosclerosis in the general population, while C-reactive protein in three groups and central augmentation index in quintiles did not. On a continuous scale, all three variables predicted severe atherosclerosis.
Key Words: Atherosclerosis • Ankle brachial index • C-reactive protein • Central augmentation index
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