Ankle brachial index, C-reactive protein, and central augmentation index to identify individuals with severe atherosclerosis

Abstract

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. © The European Society of Cardiology 2005. All rights reserved.