Tilloy Emmanuelle, Montaye Michèle, Kee Frank, Bingham Annie, Arveiler Dominique, Ruidavets Jean-Bernard, Evans Alun, Haas Bernadette, Ferrières Jean, Ducimetière Pierre, Amouyel Philippe, Dallongeville Jean
Institut Pasteur de Lille, INSERM U744, Université de Lille 2, Lille, France.
Atherosclerosis. 2009 Oct;206(2):563-8. doi: 10.1016/j.atherosclerosis.2009.03.025. Epub 2009 Apr 1.
Intermittent claudication (IC) is associated with an increased cardiovascular morbidity. The goal of the present study was to assess the contribution of conventional cardiovascular risk factors (CVRFs) to this increased risk.
The PRIME Study is a multicenter Prospective Cohort Study of 10 602 men recruited in 1991-1993, aged 50-59 at baseline and followed over 10 years. At baseline, a questionnaire on socio demographic data was self-administered and CVRFs were measured. Composite outcome consisted of incident MI, effort angina, unstable angina and coronary death. The standardized questionnaire of the London School of hygiene was used to identify claudicants. Data were analyzed using multivariate Cox models.
Probable and possible cases of IC were reported by 1.4% (135) and 4.6% (442) of subjects, respectively. Compared to subjects with no claudication, the probable cases demonstrated higher rates of CVRFs. The incidence of CAD events was 7.23/1000 person-year. Compared to non claudicants, probable claudicants had an increased age and country adjusted risk of coronary events (HR (95% CI), 2.4 (1.5-3.7), p<0.0001). After further adjustments for school duration, family history of early myocardial infarction, tobacco consumption, alcohol consumption, BMI, systolic blood pressure, antihypertensive treatment, diabetes, total cholesterol, HDL-cholesterol, triglycerides and lipid-lowering treatment, participants with probable claudication had an increased risk of coronary events but this was no longer significant (HR (95% CI), 1.3 (0.8-2.1), p=0.23).
IC is associated with an increased risk of developing coronary events. This association is largely explained by the coexistence of CVRFs.
间歇性跛行（IC）与心血管疾病发病率增加相关。本研究的目的是评估传统心血管危险因素（CVRF）对这种风险增加的影响。
PRIME研究是一项多中心前瞻性队列研究，于1991年至1993年招募了10602名男性，基线年龄为50至59岁，随访10年。在基线时，自行填写社会人口统计学数据问卷并测量CVRF。复合结局包括新发心肌梗死、劳力性心绞痛、不稳定型心绞痛和冠状动脉死亡。使用伦敦卫生学院的标准化问卷来识别跛行者。数据采用多变量Cox模型进行分析。
分别有1.4%（135名）和4.6%（442名）的受试者报告了可能和疑似IC病例。与无跛行的受试者相比，可能病例的CVRF发生率更高。CAD事件的发生率为7.23/1000人年。与非跛行者相比，可能的跛行者在年龄和国家调整后的冠状动脉事件风险增加（HR（95%CI），2.4（1.5-3.7），p<0.0001）。在进一步调整受教育年限、早期心肌梗死家族史、烟草消费、酒精消费、BMI、收缩压、抗高血压治疗、糖尿病、总胆固醇、高密度脂蛋白胆固醇、甘油三酯和降脂治疗后，可能患有跛行的参与者发生冠状动脉事件的风险增加，但不再显著（HR（95%CI），1.3（0.8-2.1），p=0.23）。
IC与发生冠状动脉事件的风险增加相关。这种关联在很大程度上是由CVRF的共存所解释的。
