Poredos Pavel, Jug Borut
Department of Vascular Diseases, University Medical Centre, Ljubljana, Slovenia.
Angiology. 2007 Jun-Jul;58(3):309-15. doi: 10.1177/0003319707302494.
Atherosclerosis is a generalized disease with considerable overlap of its coronary, carotid, and peripheral manifestations. As an indicator of multifocal atherosclerosis, peripheral arterial disease (PAD) is emerging as an important aid in risk stratification of patients with coronary artery (CAD) or cerebrovascular disease (CVD). Therefore, the aim of the study was to assess the prevalence of PAD in high risk subjects and its ability to identify coronary or cerebrovascular patients. A total of 952 (63.3% male; age 63.7 +/-10.7 years) patients at high cardiovascular risk (>or=2 risk factors), or with evidence of CAD or CVD were screened for PAD by means of ankle-brachial index (ABI) assessment; 226 patients were at high risk (>or=2 risk factors), 575 had CAD, and 151 had CVD. A total of 42% of patients with CAD and 36% of patients with CVD had PAD. In patients with CAD one half of cases of PAD were asymptomatic. Asymptomatic PAD (pathological ABI) was strongly associated with CAD and CVD, even after adjustment for age, gender, and other risk factors. No significant differences between CAD, PAD, and CVD patients were observed in terms of risk profiles. In conclusion, our findings confirm a high prevalence of both symptomatic and asymptomatic PAD in patients at high cardiovascular risk and its association with both CAD and CVD.
动脉粥样硬化是一种全身性疾病，其冠状动脉、颈动脉和外周表现有相当大的重叠。作为多灶性动脉粥样硬化的一个指标，外周动脉疾病（PAD）正成为冠状动脉疾病（CAD）或脑血管疾病（CVD）患者风险分层的重要辅助手段。因此，本研究的目的是评估高危人群中PAD的患病率及其识别冠状动脉或脑血管疾病患者的能力。通过踝臂指数（ABI）评估，对952名（男性占63.3%；年龄63.7±10.7岁）心血管高危（≥2个危险因素）或有CAD或CVD证据的患者进行了PAD筛查；226名患者为高危（≥2个危险因素），575名患有CAD，151名患有CVD。CAD患者中42%患有PAD，CVD患者中36%患有PAD。在CAD患者中，一半的PAD病例无症状。即使在调整年龄、性别和其他危险因素后，无症状PAD（病理ABI）仍与CAD和CVD密切相关。在风险特征方面，CAD、PAD和CVD患者之间未观察到显著差异。总之，我们的研究结果证实，心血管高危患者中症状性和无症状性PAD的患病率都很高，且与CAD和CVD均相关。
