Zambrzycki Bartosz, Łuczaj Michał, Dubatówka Marlena, Dańkowska Karolina, Nowicka Katarzyna, Knapp Małgorzata, Szpakowicz Anna, Kamiński Karol, Lisowska Anna
Department of Cardiology and Internal Medicine with Cardiac Intensive Care Unit, Medical University of Białystok, ul. M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland.
Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, 15-269 Białystok, Poland.
J Clin Med. 2024 Dec 23;13(24):7858. doi: 10.3390/jcm13247858.
Lower Extremity Artery Disease (LEAD) is a predictor of atherosclerotic plaques in other locations and significantly increases the risk of death from cardiovascular events. This study aimed to identify cardiology patient subpopulations that should undergo Ankle-Brachial Index (ABI) measurement. A total of 800 patients hospitalized in the Department of Cardiology were included. Inclusion criteria were age over 40 years for men and over 45 years for women, with the ability to measure ABI. The study group was divided into two subgroups based on ABI values, with LEAD (ABI ≤ 0.9) detected in 61 patients (7.6%). Among these, 45% exhibited symptoms of intermittent claudication. LEAD was significantly more common in patients with a lower ejection fraction, a history of myocardial infarction, coronary artery disease, coronary atherosclerosis, heart failure, hypercholesterolemia, diabetes, and in those with a past diagnosis of atherosclerosis. There was no statistical association with the incidence of ischemic stroke, renal failure, hypertension or a family history of cardiovascular disease. Average living conditions and financial status increased LEAD likelihood ( = 0.029; = 0.018), while physical activity reduced it ( < 0.001). LEAD occurred more often in both current and former smokers. Patients with LEAD were more likely to be on statin therapy ( = 0.002). Higher hemoglobin A1c levels significantly increased the risk of LEAD. Identifying patients with risk factors for LEAD suggests that ABI measurement should be performed to detect LEAD early and implement appropriate diagnostic and therapeutic strategies.
下肢动脉疾病（LEAD）是其他部位动脉粥样硬化斑块的一个预测指标，并且显著增加心血管事件导致的死亡风险。本研究旨在确定应接受踝臂指数（ABI）测量的心脏病患者亚组。共纳入了800名在心脏病科住院的患者。纳入标准为男性年龄超过40岁、女性年龄超过45岁，且能够测量ABI。研究组根据ABI值分为两个亚组，61名患者（7.6%）检测出患有LEAD（ABI≤0.9）。其中，45%表现出间歇性跛行症状。LEAD在射血分数较低、有心肌梗死病史、冠心病、冠状动脉粥样硬化、心力衰竭、高胆固醇血症、糖尿病的患者以及既往诊断为动脉粥样硬化的患者中明显更常见。与缺血性中风、肾衰竭、高血压的发病率或心血管疾病家族史无统计学关联。平均生活条件和经济状况增加了患LEAD的可能性（P = 0.029；P = 0.018），而体育活动则降低了这种可能性（P < 0.001）。LEAD在当前吸烟者和既往吸烟者中都更常发生。患有LEAD的患者更有可能接受他汀类药物治疗（P = 0.002）。较高的糖化血红蛋白水平显著增加了患LEAD的风险。识别有LEAD危险因素的患者表明，应进行ABI测量以早期检测LEAD并实施适当的诊断和治疗策略。
