Stroke Prevention Research Unit, University of Oxford, Oxford, UK.
Stroke. 2010 Sep;41(9):2102-7. doi: 10.1161/STROKEAHA.110.582627. Epub 2010 Aug 5.
Although peripheral artery disease (PAD) has a particularly poor prognosis compared with vascular disease in other territories, little attention is paid to its epidemiology, treatment, and prevention. Despite the high prevalence of PAD in patients with stroke, and of stroke in patients with PAD, PAD is omitted from all guidelines for treatment, prevention, and rehabilitation of stroke, although coronary artery disease risk is considered. Therefore, routine PAD screening is seldom undertaken and so disease is probably often missed. Summary of Review- This review evaluates epidemiology of PAD in patients with stroke and of stroke in patients with PAD. The role of the ankle-brachial pressure index; imaging and novel markers in risk prediction of PAD in patients with stroke; and treatment and prevention of PAD are reviewed.
In both primary and secondary prevention settings, PAD indicates a high risk of future events. Data on which additional preventive measures are beneficial in this patient group are lacking, but the presence of PAD does have implications for current management in both primary and secondary prevention of stroke.
尽管外周动脉疾病(PAD)的预后比其他部位的血管疾病尤其差,但对其流行病学、治疗和预防却很少关注。尽管 PAD 在中风患者中高发,且中风在 PAD 患者中也高发,但 PAD 却被排除在所有中风治疗、预防和康复指南之外,尽管考虑到了冠状动脉疾病的风险。因此,常规 PAD 筛查很少进行,因此疾病可能经常被忽视。综述总结- 本文综述了中风患者中 PAD 的流行病学,以及 PAD 患者中中风的流行病学。评估了踝臂血压指数的作用;影像学和新型标志物在预测中风患者 PAD 风险中的作用;以及 PAD 的治疗和预防。
在一级和二级预防中,PAD 表明未来发生事件的风险较高。缺乏关于在这个患者群体中额外的预防措施是否有益的数据,但 PAD 的存在对中风一级和二级预防的当前管理都有影响。