老年人的踝臂指数与中风、冠心病及死亡风险：弗雷明汉姆研究

The ankle-brachial index in the elderly and risk of stroke, coronary disease, and death: the Framingham Study.

作者信息

Murabito Joanne M, Evans Jane C, Larson Martin G, Nieto Kenneth, Levy Daniel, Wilson Peter W F

机构信息

National Heart, Lung, and Blood Institute's Framingham Heart Study, National Institutes of Health, Framingham, MA 01702-5827, USA.

出版信息

Arch Intern Med. 2003 Sep 8;163(16):1939-42. doi: 10.1001/archinte.163.16.1939.

DOI:10.1001/archinte.163.16.1939

PMID:12963567

Abstract

BACKGROUND

A low ankle-brachial index (ABI) is associated with an increased risk of death and cardiovascular disease. Limited data exist regarding the relation between a low ABI and stroke. We sought to examine the relation between a low ABI and stroke, coronary heart disease, and death in the elderly.

METHODS

We examined 251 men and 423 women with a mean age of 80 years who had a Framingham Study examination from 1994 to 1995. A low ABI was defined as less than 0.9. Persons were followed up for 4 years for occurrence of stroke or transient ischemic attack, coronary disease, and death. Cox proportional hazards models were used to assess the relation between a low ABI and each outcome after adjusting for age, sex, and prevalent cardiovascular disease.

RESULTS

A low ABI was detected in 20% of our sample. Only 18% of the participants with a low ABI reported claudication symptoms. One third of those with a normal ABI and 55% of those with a low ABI had cardiovascular disease at baseline. Results of multivariable Cox proportional hazards analysis demonstrated a statistically significant increase in the risk of stroke or transient ischemic attack in persons with a low ABI (hazards ratio, 2.0; 95% confidence interval, 1.1-3.7). No significant relation between a low ABI and coronary heart disease (hazards ratio, 1.2; 95% confidence interval, 0.7-2.1) or death (hazards ratio, 1.4; 95% confidence interval, 0.9-2.1) was observed.

CONCLUSIONS

A low ABI is associated with risk of stroke or transient ischemic attack in the elderly. These results need to be confirmed in larger studies.

摘要

背景

低踝臂指数（ABI）与死亡及心血管疾病风险增加相关。关于低ABI与中风之间的关系，现有数据有限。我们试图研究低ABI与老年人中风、冠心病及死亡之间的关系。

方法

我们对1994年至1995年接受弗雷明汉姆研究检查的251名男性和423名女性进行了研究，他们的平均年龄为80岁。低ABI定义为低于0.9。对这些人进行了4年的随访，观察中风或短暂性脑缺血发作、冠心病及死亡的发生情况。采用Cox比例风险模型，在调整年龄、性别和心血管疾病患病率后，评估低ABI与各结局之间的关系。

结果

我们的样本中有20%检测出低ABI。低ABI的参与者中只有18%报告有间歇性跛行症状。基线时，ABI正常者中有三分之一、低ABI者中有55%患有心血管疾病。多变量Cox比例风险分析结果显示，低ABI者中风或短暂性脑缺血发作的风险有统计学意义的显著增加（风险比，2.0；95%置信区间，1.1 - 3.7）。未观察到低ABI与冠心病（风险比，1.2；95%置信区间，0.7 - 2.1）或死亡（风险比，1.4；95%置信区间，0.9 - 2.1）之间存在显著关系。