• 作者：José ; M. Baena-Dí ; ez^a ; ^b ; ^{jbaena@imim.es} ; Marí ; a T. Alzamora^c ; ^d ; ^e ; Rosa Foré ; s^c ; Guillem Pera^e ; Pere Torá ; n^e ; Marta Sorribes^f ; en representació ; n del estudio ARTPER
• 关键词：HDL ; lipoproteí ; na de alta densidad ; ITB ; í ; ndice tobillo-brazo ; LDL ; lipoproteí ; na de baja densidad ; REGICOR ; Registre Gironí ; del Cor ; SCORE ; Systematic Coronary Risk Evaluation
• 刊名：Revista Espa帽ola de Cardiolog铆a
• 出版年：2011
• 期刊代码：pca308_03008932
• 类别：med
• 出版时间：March 2011
• 卷：64
• 期：3
• 页码：186-192
• 文件大小：180 K

Introduction and objectives

The sensitivity of cardiovascular risk functions is low because many cardiovascular events occur in low- or intermediate-risk patients. The aim of the present study was to evaluate how the ankle-brachial index (ABI) reclassifies these patients.

Methods

We conducted a descriptive, transversal, multicenter study (28 centers) of 3171 randomly selected patients aged >49 years. We studied demographic variables, clinical history and cardiovascular risk factors, ABI (defined as pathologic if <0.9) and 10-year cardiovascular risk with the Framingham-Wilson, REGICOR and SCORE equations, dividing risk into three categories: low (Framingham < 10%, REGICOR < 5%and SCORE < 2.5%, intermediate (10-19.9%, 5-9.9%and 2.5-4.9%, respectively) and high (鈮?0%, 鈮?0%and 鈮?%, respectively). Low- or intermediate-risk patients were reclassified as high-risk if they presented ABI <0.9.

Results

We compared patients with ABI <0.9 and patients with ABI 鈮?.9 and found the former were significantly older, more frequently men, had a worse history and more cardiovascular risk factors, and included more high-risk patients than when the classification used Framingham-Wilson (42.7%vs. 18.5%), REGICOR (25.8%vs. 9.3%) and SCORE (42.2%vs. 15.9%) equations. In men, using ABI led to a 5.8%increase in the high-risk category versus Framingham-Wilson, a 19.1%increase versus REGICOR and a 4.4%increase versus SCORE. In women, the increases were 78.6%versus Framingham-Wilson, 151.6%versus REGICOR and 50.0%versus SCORE.

Conclusions

The ABI reclassifies a substantial proportion of patients towards the high-risk category. This is particularly marked in women and by comparison with REGICOR scores.

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