Lamina Claudia, Meisinger Christa, Heid Iris M, Löwel Hannelore, Rantner Barbara, Koenig Wolfgang, Kronenberg Florian
Institute of Epidemiology, GSF--National Research Center for Environment and Health, Neuherberg, Germany.
Eur Heart J. 2006 Nov;27(21):2580-7. doi: 10.1093/eurheartj/ehl228. Epub 2006 Sep 4.
Peripheral arterial occlusive disease is associated with a high risk of cardiovascular morbidity and mortality. We prospectively examined the association of the ankle-brachial index (ABI) and arterial plaques in carotid and femoral arteries with incident myocardial infarctions (MIs) and cardiovascular and total mortality in 1325 participants of the population-based MONICA Augsburg Survey 1989/90.
At baseline, 6.1% of men and 2.6% of women had an ABI < or =0.9. At least one plaque in the carotid or femoral arteries was identified in 51.8% of men and 36.3% of women. During a 13-year follow-up, 58 persons (4.4%) suffered a MI before age 75 and 189 persons (14.3%) died, 86 (6.5%) of them from cardiovascular causes. Kaplan-Meier curves confirmed both measurements as strong predictors for all three endpoints (P<0.0001). Cox regression analysis revealed an increase of the risk for MI and cardiovascular and total mortality of 22 (P=0.012), 35, and 32% (P<0.00001), respectively, per 0.1 unit decrease in ABI. Correction for measurement error in ABI increased these estimates. The increase in risk for MI and cardiovascular and total mortality was 52, 70, and 45%, respectively, for each increase in the number of plaque-affected arteries (P<0.0001).
Both ABI and number of plaque-affected arteries are strong predictors for incident MI and cardiovascular and total mortality.
外周动脉闭塞性疾病与心血管疾病的高发病率和死亡率相关。我们前瞻性地研究了基于人群的1989/90年奥格斯堡莫尼卡调查的1325名参与者中，踝臂指数（ABI）以及颈动脉和股动脉中的动脉斑块与心肌梗死（MI）、心血管疾病和全因死亡率之间的关联。
在基线时，6.1%的男性和2.6%的女性ABI≤0.9。51.8%的男性和36.3%的女性在颈动脉或股动脉中至少发现了一个斑块。在13年的随访期间，58人（4.4%）在75岁之前发生了心肌梗死，189人（14.3%）死亡，其中86人（6.5%）死于心血管疾病。Kaplan-Meier曲线证实这两项测量指标都是这三个终点的强有力预测指标（P<0.0001）。Cox回归分析显示，ABI每降低0.1个单位，心肌梗死、心血管疾病和全因死亡风险分别增加22%（P=0.012）、35%和32%（P<0.00001）。对ABI测量误差进行校正后，这些估计值有所增加。每增加一条受斑块影响的动脉，心肌梗死、心血管疾病和全因死亡风险分别增加52%、70%和45%（P<0.0001）。
ABI和受斑块影响的动脉数量都是新发心肌梗死、心血管疾病和全因死亡的强有力预测指标。
