Ankle Brachial Index (ABI) predicts 2-year mortality risk among older adults in the Republic of Congo: The EPIDEMCA-FU study.

Journal: Atherosclerosis

Volume: 286

Issue: 

Year of Publication: 2020

Affiliated Institutions:  INSERM, U, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, UMR_S , Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR GEIST, F-, Limoges, France. INSERM, U, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, UMR_S , Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR GEIST, F-, Limoges, France; King's College London, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE AF, United Kingdom. Electronic address: maelenn.guerchet@unilim.fr. INSERM, U, Tropical Neuroepidemiology, Limoges, France; Department of Neurology, Brazzaville University Hospital, Brazzaville, Congo. INSERM, U, Tropical Neuroepidemiology, Limoges, France; Department of Neurology, Amitié Hospital, Bangui, Central African Republic. INSERM, U, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, UMR_S , Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR GEIST, F-, Limoges, France; Department of Vascular Medicine, Limoges University Hospital, Limoges, France. INSERM, U, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, UMR_S , Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR GEIST, F-, Limoges, France; Department of Cardiology, Limoges University Hospital, Limoges, France. INSERM, U, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, UMR_S , Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR GEIST, F-, Limoges, France; CHU, CEBIMER, Limoges, France.

Abstract summary 

Peripheral artery disease (PAD) is known to be associated with mortality in high income countries but no data regarding Sub-Saharan Africa (SSA) populations are documented. This study aimed at assessing the prognostic value of the Ankle Brachial Index (ABI) among older adults in the Republic of Congo.Congolese subjects ≥65 years were included in a longitudinal population-based survey (EPIDEMCA-FU). Demographic, biological, and clinical data were collected at baseline. PAD was defined by an ABI≤0.90. Information on mortality was collected from key informants in participants' households. Cox proportional hazard models, adjusted for traditional and cardiovascular risk factors, were fitted to evaluate the association between an ABI≤0.90 and death.1029 participants were recruited at baseline. ABI measurement was obtained from 927 participants, of whom 17.4% presented an ABI≤0.90. During a 2-year follow-up, a total of 83 (9.1%) deaths were recorded. Mortality was higher in the low-ABI group with 23 deaths (14.7%) vs. 57 (7.8%) and 3 (12.0%), respectively among those with 0.90 < ABI<1.4 and ABI≥1.40 (p = 0.039). After adjustment, an ABI≤0.90 was associated with an increased risk of mortality (HR = 1.86; 95%CI 1.04-3.87). Mortality was also independently associated with increasing age (HR = 1.05; 95%CI 1.02-1.09), dementia (HR = 2.73; 95% CI 1.15-8.05), alcohol use (HR = 0.51; 95%CI 0.29-0.88) and female sex (HR = 0.37; 95%CI 0.19-0.72).In this study, a low ABI predicted an increased mortality risk among older people. ABI may represent a simple and inexpensive tool to identify older people at high risk of death in SSA.

Authors & Co-authors:  Samba Guerchet Ndamba-Bandzouzi Kehoua Mbelesso Desormais Aboyans Preux Lacroix

Study Outcome 

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Citations : 
Authors :  9
Identifiers
Doi : 10.1016/j.atherosclerosis.2019.05.013
SSN : 1879-1484
Study Population
Female
Mesh Terms
Aged
Other Terms
Ankle-brachial index;Epidemiology;Mortality;Older adults;Peripheral artery disease;Sub-Saharan Africa
Study Design
Study Approach
Country of Study
Publication Country
Ireland