Prognostic value of low and high ankle-brachial index in hospitalized medical patients

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• 作者：Leonella Pasqualini^a ; ^{lpasqua@unipg.it} ; Giuseppe Schillaci^a ; Matteo Pirro^a ; Gaetano Vaudo^a ; Christian Leli^a ; Renato Colella^b ; Salvatore Innocente^a ; Giovanni Ciuffetti^a ; Elmo Mannarino^a
• 关键词：Asymptomatic PAD ; ABI ; Mortality ; Hospitalized medical patients
• 刊名：European Journal of Internal Medicine
• 出版年：2012
• 期刊代码：91_09536205
• 类别：med
• 出版时间：April, 2012
• 卷：23
• 期：3
• 页码：240-244
• 文件大小：320 K

摘要

Background

Peripheral arterial disease (PAD) is frequently underdiagnosed in the clinical practice, leading to a lack of opportunity to detect subjects at a high risk for cardiovascular (CV) death. The ankle-brachial pressure index (ABI) represents a noninvasive, objective tool to diagnose PAD and to predict adverse outcome.

Methods

ABI was determined by means of Doppler velocimetry, in 707 patients, aged 50 years or older, consecutively hospitalized in an internal medicine ward, who were followed-up for at least 12 months in order to assess all-cause and CV mortality.

Results

Symptomatic PAD affected 8%of the population while the prevalence of PAD, defined as ABI < 0.90, was 29%; high ABI (> 1.40) was found in 8%of the patients. After a mean follow-up period of 1.6 years, both low and high ABI were independently associated with CV mortality with a hazard ratio of 1.99 (p = 0.016) for low and 2.13 (p = 0.04) for high ABI, compared with normal ABI (0.90-1.40). High ABI also independently predicted all-cause mortality with a hazard ratio of 1.77 (p = 0.04).

Discussion

ABI measurement reveals a large number of individuals with asymptomatic PAD among those hospitalized in an internal medicine department. An increased mortality was observed in patients with both low and high ABI. Hospital admission for any reason may serve as an opportunity to detect PAD and start appropriate preventive actions.