Abstract 271: Lack Of Prognostic Value Of High Ankle Brachial Pressure Index (ABI) In Patients With Advanced Heart Failure

Abstract

Introduction: Ankle brachial pressure index (ABI) is a noninvasive test to diagnose peripheral arterial disease (PAD). Abnormally high ABI has been associated with increased LV mass and mortality in patients free of cardiovascular disease, while low ABI is often indicative of PAD that portends poor prognosis. But the prognostic significance of high ABI in advanced heart failure patients has not been studied. Methods: We reviewed 342 consecutive patients with advanced heart failure who underwent transplant evaluation between 2007 and 2011. Patients with history of PAD or ABI < 0.9 on either side were excluded. ABI values on both sides were added to create total ABI. Based on this total ABI, patients were divided into tertiles. Survival (death or heart transplant) analysis was assessed by Kaplan-Meier curves in different tertiles. Results: Mean total ABI was 2.29 ± 0.39. Mortality/transplant rates were 52.4%, 43.2% and 50.4% in increasing ABI tertiles. Kaplan-Meier survival analysis did not show any statistically significant prognostic importance (log rank, p = 0.39, Figure.1). Similar results were obtained when patients with ischemic (p = 0.094) and non-ischemic cardiomyopathy (p =0.899) were analyzed separately. ABI was not an independent predictor of mortality in Cox regression analysis (HR 0.95, 95% CI 0.66, 1.36). Conclusion: Higher tertiles of ABI were not associated with poor prognosis in patients with stage D heart failure. This remained true for both ischemic and non-ischemic cardiomyopathy.