Ankle-brachial Index for the Prognosis of Cardiovascular Disease in Patients with Mild Renal Insufficiency

Safety Evaluation and Effect Deconstruction of Blood Lipid Test in the Diagnosis of Cardiovascular Disease Patients

With the increase in the number of cardiovascular patients in China, this paper must use better detection methods to examine these patients. Blood lipid testing is a quantitative method for the determination of lipids contained in blood (plasma). Blood lipids are the general term for neutral fats (triglycerides and cholesterol) and lipids (phospholipids, glycolipids, sterols, and steroids) in plasma, which are widely present in the human body. At the same time, this paper also applies this technology to different examination procedures at various current stages. Cardiovascular disease, also known as circulatory system disease, is a series of diseases involving the circulatory system. The circulatory system refers to the organs and tissues that transport blood in the human body, mainly including the heart and blood vessels (arteries, veins, and microvessels), which can be subdivided into acute and chronic and are generally related to arteriosclerosis. In recent years, the most widely used is blood lipid measurement. Therefore, this paper proposes a study on the safety evaluation and effect analysis of blood lipid testing in the diagnosis of cardiovascular disease patients. This article focuses on the causes of cardiovascular disease and introduces the purpose, methods, results, and conclusions of blood lipid detection. Combined with the deep learning method combined with wavelet analysis and support vector machine (SVM), the in-depth analysis is carried out, and suitable patients are selected for blood lipid detection. The final experimental results showed that apolipoprotein B (APOB), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and other indicators were significantly different from the control group. The values of apolipoprotein A1 (APOA1) and high-density lipoprotein cholesterol (HDL-C) were significantly different from those in the control group, $P<0.05$ . This shows that blood lipid examination has a good effect on the diagnosis of cardiovascular patients; it can make accurate diagnosis and prediction of the patient’s condition and has good clinical application value.

Combination of low ankle-brachial index and high ankle-brachial index difference for mortality prediction

Low ankle-brachial index (ABI) and high ABI difference (ABID) are each associated with poor prognosis. No study has assessed the ability of the combination of low ABI and high ABID to predict survival. We created an ABI score by assigning 1 point for ABI < 0.9 and 1 point for ABID ≥ 0.17 and examine the ability of this ABI score to predict mortality. We included 941 patients scheduled for echocardiographic examination. The ABI was measured using an ABI-form device. ABID was calculated as |right ABI-left ABI|. Among the 941 subjects, the prevalence of ABI < 0.9 and ABID ≥ 0.17 was 6.1% and 6.8%, respectively. Median follow-up to mortality was 93 months. There were 87 cardiovascular and 228 overall deaths. All ABI-related parameters, including ABI, ABID, ABI < 0.9, ABID ≥ 0.17, and ABI score, were significantly associated with overall and cardiovascular mortality in the multivariable analysis (P ≤ 0.009). Further, in the direct comparison of multivariable models, the basic model + ABI score was the best at predicting overall and cardiovascular mortality among the five ABI-related multivariable models (P ≤ 0.049). Hence, the ABI score, a combination of ABI < 0.9 and ABID ≥ 0.17, should be calculated for better mortality prediction.

Peripheral arterial disease diagnosed by ankle-brachial index: Predictor for early renal replacement therapy in chronic kidney disease

Our study aimed to investigate the relationship between ankle-brachial index (ABI) and need for early renal replacement therapy (RRT) in predialysis patients with chronic kidney disease (CKD). A total of 112 patients (62% men) with pre-dialysis CKD, seen in the outpatient clinic, were included, and ABI was obtained as per standard protocol. Peripheral arterial disease (PAD) was defined as ABI <0.9 or >1.3 in either leg. The clinical data were analyzed, and the risk factors for early RRT were determined by multivariate logistic regression analysis. The prevalence of PAD was 44% in predialysis CKD patients. Over three years' follow- up, 14.2% required RRT; 11.3% developed major cardiovascular event (myocardial infarction, stroke, or death). A total of 26 events occurred. The incidence of all events was significantly higher in patients with abnormal ABI than in those with normal ABI (34.7% vs. 12.7%; log rank P = 0.02). PAD was associated with all events [hazard ratio (HR): 2.72; 95% CI: 1.04-7.17; P = 0.042] as also the need for RRT (HR 3.2; 95% Cl: 1.005-10.23; P = 0.049), on univariate cox proportional hazard analysis. Multivariate logistic regression analysis adjusted for other risk factors identified that PAD remained an independent predictor for the need for early RRT (HR: 12.2; 95%Cl: 2.2-66.5; P = 0.004) and all events (HR: 3.5; 95% Cl: 0.9-13.5; P = 0.032). PAD was an independent predictor for RRT requirement in predialysis CKD.

A retrospective study of arterial stiffness and subsequent clinical outcomes in cancer patients undergoing percutaneous coronary intervention

OBJECTIVE

Increasing attention is being paid to the relationship between cancer and cardiovascular diseases. In this study, we examined arterial stenosis and stiffness in patients with malignant diseases requiring percutaneous coronary intervention.

METHODS

This was a retrospective, single-center, observational study. Participants (n = 1003) were divided into a malignant group, with current or past malignant disease, and a nonmalignant group. The ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) were evaluated. The endpoint was a composite of cardiovascular death, nonfatal myocardial infarction, stroke, and revascularization within 1 year.

RESULTS

We observed significantly impaired ABI and baPWV in the malignant group. A total of 148 patients had a cardiovascular event. Kaplan-Meier analysis showed a significantly higher probability of cardiovascular events in the malignant group (P = 0.012). The combination of malignancy with ABI/baPWV identified subgroups with significantly different probabilities of cardiovascular events. Multivariate Cox hazard analysis identified malignancy as an independent predictor of cardiovascular events (hazard ratio, 1.54; 95% confidence interval, 1.06-2.26; P = 0.025) with an increased hazard ratio by adding the status of low ABI/high baPWV to malignancy (hazard ratio, 2.36; 95% confidence interval, 1.35-4.12; P = 0.003). We found significantly higher follow-up baPWV values in the malignancy group (P = 0.016).

CONCLUSION

Atherosclerosis is advanced and accelerated in patients with malignancy, and these patients had significantly higher rates of adverse cardiovascular events, and their risk might be stratified by ABI and baPWV.

REGISTRATION

University Hospital Medical Information Network-CTR (http://www.umin.ac.jp/ctr/).

IDENTIFIER

Kumamoto University Malignancy and Atherosclerosis study (UMIN000028652).

PUBLIC ACCESS INFORMATION

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