Bertomeu V, Morillas P, Gonzalez-Juanatey J R, Quiles J, Guindo J, Soria F, Llacer A, Lekuona I, Mazón P, Martín-Luengo C, Rodriguez-Padial L
Hospital Universitario de San Juan, Alicante, Spain.
Hospital Universitario de San Juan, Alicante, Spain.
Eur J Vasc Endovasc Surg. 2008 Aug;36(2):189-196. doi: 10.1016/j.ejvs.2008.02.004. Epub 2008 Mar 28.
A significant proportion of patients with ischemic heart disease have associated peripheral arterial disease (PAD), but many are asymptomatic and this condition remains underdiagnosed. We aimed to study the prevalence of PAD in patients with an acute coronary syndrome (ACS) and to evaluate its influence in hospital clinical outcomes.
The PAMISCA register is a prospective, multicenter study involving patients >or=40 years old with ACS admitted to selected Spanish hospitals. All patients had their ankle-brachial index (ABI) measured between days 3 and 7 after the ischemic event.
1410 ACS patients (71.4% male) were included. PAD determined by ABI was documented in 561 patients (39.8%). Factors independently related to PAD were age (OR: 1.04; 95% CI: 1.03-1.06; p<0.001), smoking (OR: 1.88; 95% CI: 1.41-2.49; p<0.0001), diabetes (OR: 1.30; 95% CI: 1.02-1.65; p<0.05), previous cardiac disease (OR: 1.54; 95% CI: 1.22-1.95; p<0.001) and previous cerebrovascular disease (OR: 1.90; 95% CI: 1.28-2.80; p<0.001). Following the ACS, an ABI<or=0.90 was associated with increased cardiovascular mortality (OR: 5.45; 95% CI: 1.16-25.59; p<0.05) and a higher risk of cardiovascular complications.
The prevalence of PAD in patients >or=40 years presenting with ACS is high and it is associated with increased cardiovascular risk.
相当一部分缺血性心脏病患者合并有外周动脉疾病（PAD），但许多患者无症状，这种情况仍未得到充分诊断。我们旨在研究急性冠状动脉综合征（ACS）患者中PAD的患病率，并评估其对医院临床结局的影响。
PAMISCA登记研究是一项前瞻性、多中心研究，纳入年龄≥40岁、因ACS入住西班牙选定医院的患者。所有患者在缺血事件发生后第3至7天测量踝臂指数（ABI）。
纳入1410例ACS患者（男性占71.4%）。通过ABI确定的PAD在561例患者（39.8%）中得到记录。与PAD独立相关的因素有年龄（比值比：1.04；95%置信区间：1.03 - 1.06；p<0.001）、吸烟（比值比：1.88；95%置信区间：1.41 - 2.49；p<0.0001）、糖尿病（比值比：1.30；95%置信区间：1.02 - 1.65；p<0.05）、既往心脏病史（比值比：1.54；95%置信区间：1.22 - 1.95；p<0.001）和既往脑血管病史（比值比：1.90；95%置信区间：1.28 - 2.80；p<0.001）。ACS发生后，ABI≤0.90与心血管死亡率增加（比值比：5.45；95%置信区间：1.16 - 25.59；p<0.05）及心血管并发症风险较高相关。
年龄≥40岁的ACS患者中PAD患病率较高，且与心血管风险增加相关。
