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Ankle-brachial indices and risk of cardiovascular complications


Authors: L. Válková;  E. Leichterová;  J. Válek
Authors‘ workplace: Institut pro vzdělávání lékařů ve zdravotnictví, Praha ;  Ředitel: MUDr. Zdeněk Hadra ;  Katedra všeobecného lékařství
Published in: Prakt. Lék. 2008; 88(4): 220-223
Category: Of different specialties

Overview

Aim:
the aim of the study was to verify the importance of using the ankle-brachial index for the prediction of cardiovascular complications in a three year pilot study of middle-aged men.

Material and methods:
A cohort of 442 males, followed in the consulting rooms of 14 general practices, was enrolled. Ankle-brachial index assessed with hand held continuous Doppler ultrasound for the measurement of blood pressure was calculated from the left (ABS), right (ABD) and both legs (ABI) and related to the arm pressures. Cumulative incidence of all signs of disease progression (invasive intervention on the peripheral arteries, coronary arteries, myocardial infarction and cerebrovascular events) occurring between years 2001–2004 was analyzed.

Results:
Mean ankle-brachial index ranged from 1.10 to 1.08 on either leg. Decreased values (<0.9) were found from 10.6 % males (ABI) to 12.4% (ABD). Cardiovascular complications were encountered in 32 men (7.3 %). Their ankle brachial indices were highly significantly decreased as compared with those of men without complications.

Conclusions:
Statistically significant relationship between cardiovascular complications and ankle-brachial indices were found even taking into account the age, blood pressure and symptoms of the metabolic syndrome. Decreased ankle-brachial index may contribute to the prediction of cardiovascular risk of middle aged men with a low to moderate risk, which might improve prevention in general practice.

Key words:
Ankle-brachial index, myocardial infarction, cardiovascular complications, prevention, primary care.


Sources

1. Armitage, P., Berry, G., Mathews, J.N. Statistical methods in medical research. Moldon, Massachusetts: Blackwell Science, 2005.

2. Aboyans, V., Lacroix, P., Postil, A. et al. Subclinical peripheral arterial disease and incompresible ankle arteries are both long term prognostic factors in patiens undergoing coronary artery bypass grafting. J. Amer. Coll. Cardiol. 2005, 46, p. 815-820.

3. Carbayo, J.A., Division, B.A., Lipéz-Abril, J. et al. Using ankle- brachial index to detect peripheral arterial disease: Prevalence and associated risk factors in a randomized population sample. Nutr. Metab. Cardiovasc. Dis. 2007, 17, p. 41-49.

4. Cífková, R., Býma, S., Češka, R. a kol. Prevence kardiovaskulárních nemocí v dospělém věku. Vnitř. lék. 2005, 51, s. 1021-1036.

5. Diehm, C., Lange, S., Darius, H. Association of low ankle brachial index with high mortality in primary care. Eur. Heart J. 2006, 27, p. 1743-1749.

6. Dobay, A. V., Nand, S.A. Sensitivity and specificity of the ankle- brachial index to predict future cardiovascular outcomes. Arteriocler. Thromb. Vascular Biol. 2005, 25, p. 1463-1479.

7. McDermott, M.M., Liu, K., Criqui, M.H. et al. Ankle brachial index and subclinical cardiac and carotid disease. Amer. J. Epidemiol., 2005, 162, p. 33-41.

8. Hirsch, A.T., Gotto, A.M. Undertreatment of dyslipidemia in peripheral arterial disease, an opportunity for cardiovascular disease reduction. Vascular. Med. 2002, 7, p. 323-331.

9. Kunti, K. Screening for peripheral vascular disease in primary care. Brit. J. Cardiol. 2003, 10, p. 315-317.

10. Lee, A.J., Price, J.F., Russek, M.J. et al. Improved prediction of fatal myocardial infarction using the ankle brachial index in addition to conventional risk factors: The Edinburgh Artery Study. Circulation 2004, 110, p. 3075-3080.

11. Mark, D.B. Decision-making in clinical medicine. In Harrison’s Principles of internal medicíne. New York: Mc Graw- Hill, 2005, p. 6-13.

12. Mehler, P.S., Coll, R.J., Estacio, R. et al. Intensive blood pressure control reduces the risk of cardiovascular events in patiens with peripheral arterial disease and type 2 diabetes. Circulation 2003, 107, p. 753-757.

13. Norman, P.E., Davis, W.A., Bruce, D.G. et al. Peripheral arterial disease and risk of cardiac death in type 2 diabetes.The Fremantle Diabetes Study. Diabetes Care 2006, 29, p. 575-580.

14. Resnick, H.E., Lindsay, R.S., Mc Dermot, G.M. et al. Relationship of high and low ankle brachial index to all cause and cardiovascular disease mortality. Circulation 2004, 109, p. 733-740.

15. Rose, G.A., Blackburn, A. Cardiovascular Survey Methods. Geneve: WHO, 1968, 188 p.

16. Selvin, E., Erlinger, T.P. Prevalence nad risk factors for peripheral arterial disease in the United States. Circulation 2004, 110, p. 738-743.

17. Válek, J., Válková, L. Kotníkové indexy mužů středního věku - prevence aterosklerózy v primární péči. Prakt. lék., 2004, 84, p. 529-532.

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