Buso Giacomo, Darioli Roger, Calanca Luca, Depairon Michèle, Schwitter Jürg, Mazzolai Lucia, Alatri Adriano
Division of Angiology, Heart and Vessel Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
University of Lausanne, Lausanne, Switzerland.
Eur J Intern Med. 2022 May;99:63-69. doi: 10.1016/j.ejim.2022.02.002. Epub 2022 Feb 5.
Lower limb peripheral arterial disease (PAD) is a leading atherosclerotic disease in the elderly. However, awareness of the disease is poor, particularly in women.
In this retrospective, cross-sectional study, postmenopausal women referred to our Angiology Division were tested for PAD, defined as an "ankle-brachial index" (ABI) ≤0.9 or ≥1.4 (in the latter case with a "toe-brachial index" <0.7), or a history of lower limb arterial revascularization. Aim of our study was to assess cardiovascular (CV) risk profile in postmenopausal women with and without PAD, and to evaluate the role of PAD and six classic CV risk factors (CVRFs), namely age, current smoking, hypertension, dyslipidaemia, severe chronic renal failure, and diabetes in predicting CV disease (CVD), defined as coronary artery disease and/or cerebrovascular disease.
Overall, 850 patients were included, 39.4% of whom with PAD. Compared with women without PAD, those with PAD were older (75.2 vs 66 years, respectively; p <0.001), and displayed higher rates of other CVRFs (p <0.001 for each). A personal history of CVD was reported in 18.8% of women with PAD and in 6.1% of those without PAD (p <0.001). At multivariate regression analysis, PAD (odds ratio [OR]: 2.15; 95% confidence interval [CI]: 1.33-3.47), and hypertension (OR: 2.20; 95%CI: 1.24-3.88) were the strongest factors associated with CVD presence.
PAD is a strong marker of CVD in this selected series of postmenopausal women. If confirmed in the general population, PAD screening through ABI calculation may be considered for CV risk assessment in postmenopausal women.
下肢外周动脉疾病（PAD）是老年人中主要的动脉粥样硬化疾病。然而，对该疾病的认知较差，尤其是在女性中。
在这项回顾性横断面研究中，转诊至我们血管病科的绝经后女性接受了PAD检测，PAD定义为“踝臂指数”（ABI）≤0.9或≥1.4（在后一种情况下“趾臂指数”<0.7），或有下肢动脉血运重建史。我们研究的目的是评估有和没有PAD的绝经后女性的心血管（CV）风险概况，并评估PAD和六个经典的CV危险因素（CVRFs），即年龄、当前吸烟、高血压、血脂异常、严重慢性肾衰竭和糖尿病在预测CV疾病（CVD，定义为冠状动脉疾病和/或脑血管疾病）中的作用。
总体而言，纳入了850名患者，其中39.4%患有PAD。与没有PAD的女性相比，患有PAD的女性年龄更大（分别为75.2岁和66岁；p<0.001），并且其他CVRFs的发生率更高（每种情况p<0.001）。18.8%患有PAD的女性和6.1%没有PAD的女性报告有CVD个人史（p<0.001）。在多变量回归分析中，PAD（优势比[OR]：2.15；95%置信区间[CI]：1.33 - 3.47）和高血压（OR：2.20；95%CI：1.24 - 3.88）是与CVD存在相关的最强因素。
在这一选定的绝经后女性系列中，PAD是CVD的一个强有力的标志物。如果在一般人群中得到证实，通过计算ABI进行PAD筛查可考虑用于绝经后女性的CV风险评估。
