Hiramoto Jade S, Katz Ronit, Ix Joachim H, Wassel Christina, Rodondi Nicolas, Windham B Gwen, Harris Tamara, Koster Annemarie, Satterfield Suzanne, Newman Anne, Shlipak Michael G
Department of Surgery, University of California, San Francisco, CA.
Vascular. 2014 Apr;22(2):142-8. doi: 10.1177/1708538113476023. Epub 2013 May 13.
The objective of the study was to determine if there are sex-based differences in the prevalence and clinical outcomes of subclinical peripheral artery disease (PAD). We evaluated the sex-specific associations of ankle-brachial index (ABI) with clinical cardiovascular disease outcomes in 2797 participants without prevalent clinical PAD and with a baseline ABI measurement in the Health, Aging, and Body Composition study. The mean age was 74 years, 40% were black, and 52% were women. Median follow-up was 9.37 years. Women had a similar prevalence of ABI < 0.9 (12% women versus 11% men; P = 0.44), but a higher prevalence of ABI 0.9-1.0 (15% versus 10%, respectively; P < 0.001). In a fully adjusted model, ABI < 0.9 was significantly associated with higher coronary heart disease (CHD) mortality, incident clinical PAD and incident myocardial infarction in both women and men. ABI < 0.9 was significantly associated with incident stroke only in women. ABI 0.9-1.0 was significantly associated with CHD death in both women (hazard ratio 4.84, 1.53-15.31) and men (3.49, 1.39-8.72). However, ABI 0.9-1.0 was significantly associated with incident clinical PAD (3.33, 1.44-7.70) and incident stroke (2.45, 1.38-4.35) only in women. Subclinical PAD was strongly associated with adverse CV events in both women and men, but women had a higher prevalence of subclinical PAD.
本研究的目的是确定亚临床外周动脉疾病（PAD）的患病率和临床结局是否存在性别差异。我们在健康、衰老和身体成分研究中，对2797名无临床PAD且有基线踝臂指数（ABI）测量值的参与者，评估了ABI与临床心血管疾病结局的性别特异性关联。平均年龄为74岁，40%为黑人，52%为女性。中位随访时间为9.37年。女性ABI<0.9的患病率与男性相似（女性为12%，男性为11%；P=0.44），但ABI为0.9 - 1.0的患病率更高（分别为15%和10%；P<0.001）。在一个完全调整的模型中，ABI<0.9与女性和男性的较高冠心病（CHD）死亡率、新发临床PAD和新发心肌梗死显著相关。ABI<0.9仅在女性中与新发中风显著相关。ABI为0.9 - 1.0在女性（风险比4.84，1.53 - 15.31）和男性（3.49，1.39 - 8.72）中均与CHD死亡显著相关。然而，ABI为0.9 - 1.0仅在女性中与新发临床PAD（3.33，1.44 - 7.70）和新发中风（2.45，1.38 - 4.35）显著相关。亚临床PAD在女性和男性中均与不良心血管事件密切相关，但女性亚临床PAD的患病率更高。
