TY - JOUR
T1 - Femoral artery plaque characteristics, lower extremity collaterals, and mobility loss in peripheral artery disease
AU - McDermott, Mary M.
AU - Carroll, Timothy
AU - Carr, James
AU - Yuan, Chun
AU - Ferrucci, Luigi
AU - Guralnik, Jack M.
AU - Kibbe, Melina
AU - Criqui, Michael H.
AU - Tian, Lu
AU - Polonsky, Tamar
AU - Zhao, Lihui
AU - Gao, Ying
AU - Hippe, Daniel S.
AU - Xu, Dongxiang
AU - McCarthy, Walter
AU - Kramer, Christopher M.
N1 - Funding Information:
The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Chun Yuan received grant funding from Philips Healthcare and is a member of Philips Radiology Medical Advisory Network (RMAN). Dr Kramer and Dr McDermott receive research funding from Novartis. Mr Hippe receives grant funding from Philips Healthcare and GE Healthcare.
Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: funded by the National Heart, Lung, and Blood Institute, R01-HL109244 and R01-HL083064.
Publisher Copyright:
© The Author(s) 2017.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Little is known about the prognostic significance of specific characteristics of magnetic resonance imaging (MRI) measured plaque in the superficial femoral artery (SFA). Associations of MRI-measured plaque quantity, lumen area, and plaque composition in the SFA with subsequent mobility loss were studied in people with lower extremity peripheral artery disease (PAD). Participants with an ankle–brachial index (ABI) < 1.00 were identified from Chicago medical centers and underwent direct visualization of atherosclerotic plaque in the SFA using MRI. Participants were followed annually for up to 4 years. Mobility loss was defined as becoming unable to walk up and down a flight of stairs or walk one-quarter of a mile without assistance among participants without mobility impairment at baseline. Analyses adjusted for age, sex, race, comorbidities, ABI, physical activity, and other confounders. Of 308 PAD participants without baseline mobility impairment, 100 (32.5%) developed mobility loss during follow-up. Compared to the lowest mean plaque area tertile at baseline, participants in the highest (worst) plaque area tertile had a higher rate of mobility loss (hazard ratio (HR) = 2.08, 95% confidence interval (CI) = 1.14–3.79, p = 0.018). Compared to the highest mean lumen area tertile, the smallest (worst) mean lumen area tertile was associated with greater mobility loss (HR = 2.18, 95% CI = 1.20–3.96, p = 0.011). Neither lipid rich necrotic core nor calcium in the SFA were associated with mobility loss. In conclusion, greater plaque quantity and smaller lumen area in the proximal SFA, but not lipid rich necrotic core or calcium, were associated with higher mobility loss in people with PAD.
AB - Little is known about the prognostic significance of specific characteristics of magnetic resonance imaging (MRI) measured plaque in the superficial femoral artery (SFA). Associations of MRI-measured plaque quantity, lumen area, and plaque composition in the SFA with subsequent mobility loss were studied in people with lower extremity peripheral artery disease (PAD). Participants with an ankle–brachial index (ABI) < 1.00 were identified from Chicago medical centers and underwent direct visualization of atherosclerotic plaque in the SFA using MRI. Participants were followed annually for up to 4 years. Mobility loss was defined as becoming unable to walk up and down a flight of stairs or walk one-quarter of a mile without assistance among participants without mobility impairment at baseline. Analyses adjusted for age, sex, race, comorbidities, ABI, physical activity, and other confounders. Of 308 PAD participants without baseline mobility impairment, 100 (32.5%) developed mobility loss during follow-up. Compared to the lowest mean plaque area tertile at baseline, participants in the highest (worst) plaque area tertile had a higher rate of mobility loss (hazard ratio (HR) = 2.08, 95% confidence interval (CI) = 1.14–3.79, p = 0.018). Compared to the highest mean lumen area tertile, the smallest (worst) mean lumen area tertile was associated with greater mobility loss (HR = 2.18, 95% CI = 1.20–3.96, p = 0.011). Neither lipid rich necrotic core nor calcium in the SFA were associated with mobility loss. In conclusion, greater plaque quantity and smaller lumen area in the proximal SFA, but not lipid rich necrotic core or calcium, were associated with higher mobility loss in people with PAD.
KW - atherosclerotic plaque
KW - intermittent claudication
KW - lipid rich necrotic core
KW - mobility
KW - peripheral artery disease (PAD)
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U2 - 10.1177/1358863x17729030
DO - 10.1177/1358863x17729030
M3 - Article
C2 - 28965473
AN - SCOPUS:85038226679
SN - 1358-863X
VL - 22
SP - 473
EP - 481
JO - Vascular Medicine (United Kingdom)
JF - Vascular Medicine (United Kingdom)
IS - 6
ER -