Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2013 Jan;28(1):87-92. doi: 10.3346/jkms.2013.28.1.87. Epub 2013 Jan 8.
Peripheral artery disease (PAD) is an important marker for the risk stratification of patients with coronary artery disease (CAD). We investigated the prevalence of PAD in patients undergoing percutaneous coronary intervention (PCI) with CAD and the relationship between ankle-brachial pressure index (ABPI) and CAD severity. A total of 711 patients undergoing PCI for CAD from August 2009 to August 2011 were enrolled. PAD diagnosis was made using the ABPI. The prevalence of PAD was 12.8%. In PAD patients, mean values of right and left ABPI were 0.71 ± 0.15 and 0.73 ± 0.15. Patients with PAD had a higher prevalence of left main coronary disease (14.3% vs 5.8%, P = 0.003), more frequently had multivessel lesions (74.9% vs 52.1%, P < 0.001) and had higher SYNTAX score (18.2 ± 12.3 vs 13.1 ± 8.26, P = 0.002). Using multivariate analysis, we determined that left main CAD (OR, 2.954; 95% CI, 1.418-6.152, P = 0.004) and multivessel CAD (OR, 2.321; 95% CI, 1.363-3.953, P = 0.002) were both independently associated with PAD. We recommend that ABPI-based PAD screening should be implemented in all patients undergoing PCI with CAD, especially in severe cases.
外周动脉疾病(PAD)是冠心病(CAD)患者风险分层的一个重要标志物。我们研究了经皮冠状动脉介入治疗(PCI)的 CAD 患者中 PAD 的患病率以及踝肱血压指数(ABPI)与 CAD 严重程度的关系。2009 年 8 月至 2011 年 8 月期间,共纳入 711 例行 PCI 治疗 CAD 的患者。采用 ABPI 诊断 PAD。PAD 的患病率为 12.8%。在 PAD 患者中,右、左侧 ABPI 的平均值分别为 0.71 ± 0.15 和 0.73 ± 0.15。PAD 患者中左主干冠状动脉疾病的患病率更高(14.3%比 5.8%,P = 0.003),多支血管病变的发生率更高(74.9%比 52.1%,P < 0.001),SYNTAX 评分更高(18.2 ± 12.3 比 13.1 ± 8.26,P = 0.002)。多变量分析确定,左主干 CAD(OR,2.954;95%CI,1.418-6.152,P = 0.004)和多支血管 CAD(OR,2.321;95%CI,1.363-3.953,P = 0.002)均与 PAD 独立相关。我们建议,在所有接受 CAD 行 PCI 的患者中,应实施基于 ABPI 的 PAD 筛查,尤其是在严重病例中。