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Background Measurement of the ankle brachial index (ABI) is a simple, noninvasive means of diagnosing peripheral arterial disease, and has been shown to be associated with mortality rate. Here, we examined the association between ABI and physical function in patients with heart failure (HF). Methods The study population consisted of 524 admitted patients (67.2 ± 13.9 years, 343 males) with HF. Blood pressure and the ABI were determined by oscillometry. Prior to hospital discharge, ABI, 6-minute walking distance, walking velocity, handgrip strength, quadriceps isometric strength, and standing balance were determined. The 524 patients were divided according to ABI as follows: ABI ≤ 0.90 (low ABI), ABI 0.91 to 0.99 (borderline ABI), and ABI 1.00 to 1.40 (normal ABI). Results Lower ABI values were associated with shorter 6-minute walking distance (p trend = 0.001), slower walking velocity (p trend = 0.023), and poorer standing balance (p trend = 0.048). There were no significant associations between ABI and handgrip strength or quadriceps isometric strength. After adjusting for potential confounders, patients with ABI ≤ 0.90 had shorter 6-minute walking distance compared to those with ABI 1.00 to 1.40 (adjusted mean value: 344 m vs. 395 m, respectively, p < 0.001). There were no significant differences in any of the other physical function parameters examined. Conclusions In patients with HF, low ABI is associated with the magnitude of impairment in walking endurance. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Diabetes mellitus and low ankle brachial index (ABI) are both conditions associated with an increased cardiovascular risk. In the setting of an acute coronary syndrome (ACS), diabetes is associated with increased mortality, but little is known regarding a low ABI. The aim of the study was to evaluate the prevalence of diabetes and low ABI in patients after an ACS and their prognostic value. Methods: 1156 patients ≥40years admitted with an ACS were screened with ABI previous to hospital discharge to investigate the presence of peripheral arterial disease (PAD) (ABI value≤0.9). 1054 were finally followed for one year. Patients were stratified according to diabetes and PAD status. The primary endpoint of the study was all-cause mortality. Results: The prevalence of diabetes was 36% and PAD was 39.9%. After a median follow up of 382 days, 59 patients died (5.6%), the majority from a cardiovascular event. In both diabetic and nondiabetic patients, the presence of PAD was significantly associated with an increased incidence of the primary event. After adjustment for several prognostic variables, patients with diabetes and PAD had an increased risk of mortality (HR 4.05 (95% CI 1.86-8.83)). PAD and diabetic patients had an intermediate and similar incidence of cardiovascular events. Conclusions: Our results show that the presence of an ABI≤0.9 predicts cardiovascular risk to the same extent as diabetes, and the combination of diabetes and PAD is a powerful tool after an ACS to predict the occurrence of an adverse event. [Copyright &y& Elsevier]