OBJECTIVE: To study the relationship between the presence of peripheral artery disease (PAD) and the morbidity and mortality at 6 years, and the ankle-brachial index (ABI) as a predictor of morbidity and mortality in type 2 diabetes mellitus. DESIGN: Retrospective cohort study. Six years follow-up. SETTING: Urban health centre. PARTICIPANTS: A total of 269 type 2 diabetics, of which 63 had PAD in 1996: 20 were previously diagnosed and 43 had an ABI of < or =0.90. PRINCIPAL MEASUREMENTS: An appointed was made with the patients to find out the incidence of fatal and non-fatal microvascular and macrovascular events and the histories were reviewed. Six patients were excluded as all their data were not available. RESULTS: Thirty nine patients had died, of whom 19 had PAD in 1996 (30.1%) and 20 did not (9.7%) (P = .001). Sixteen patients died in the group with an ABI < or =0.9 (30.2%) and 21 (10.1%) in the group with normal ABI values (P = .001). 7 (13.2%) patients died due to a cardiovascular cause with a pathological ABI, and 8 (3.9%) with a normal value (P = .009). The presence of PAD has been associated with a higher probability of having a non-fatal episode of ischaemic cardiac disease (P = .04), a cerebrovascular accident (CVA) (P < .001) and ulcers (P = .006). A low ABI has been associated with a higher probability of presenting with a fatal or non-fatal cardiovascular event (P < .001). After the multivariate analysis an increase was observed in cardiovascular (odds ratio [OR] =2.81; 95% confidence interval [CI], 1.16-6.78), CVA (OR = 3.47; 95% CI, 1.19-10.07), and cardiac failure (OR = 6.75; 95% CI, 1.34-33.81), morbidity and mortality in diabetics with an ABI of < or = 0.90. CONCLUSIONS: The type 2 diabetics with PAD present with a higher morbidity and mortality. The ABI is a good predictor of cardiovascular disease and heart failure morbidity and mortality.
OBJECTIVE: To study the relationship between the presence of peripheral artery disease (PAD) and the morbidity and mortality at 6 years, and the ankle-brachial index (ABI) as a predictor of morbidity and mortality in type 2 diabetes mellitus. DESIGN: Retrospective cohort study. Six years follow-up. SETTING: Urban health centre. PARTICIPANTS: A total of 269 type 2 diabetics, of which 63 had PAD in 1996: 20 were previously diagnosed and 43 had an ABI of < or =0.90. PRINCIPAL MEASUREMENTS: An appointed was made with the patients to find out the incidence of fatal and non-fatal microvascular and macrovascular events and the histories were reviewed. Six patients were excluded as all their data were not available. RESULTS: Thirty nine patients had died, of whom 19 had PAD in 1996 (30.1%) and 20 did not (9.7%) (P = .001). Sixteen patients died in the group with an ABI < or =0.9 (30.2%) and 21 (10.1%) in the group with normal ABI values (P = .001). 7 (13.2%) patients died due to a cardiovascular cause with a pathological ABI, and 8 (3.9%) with a normal value (P = .009). The presence of PAD has been associated with a higher probability of having a non-fatal episode of ischaemic cardiac disease (P = .04), a cerebrovascular accident (CVA) (P < .001) and ulcers (P = .006). A low ABI has been associated with a higher probability of presenting with a fatal or non-fatal cardiovascular event (P < .001). After the multivariate analysis an increase was observed in cardiovascular (odds ratio [OR] =2.81; 95% confidence interval [CI], 1.16-6.78), CVA (OR = 3.47; 95% CI, 1.19-10.07), and cardiac failure (OR = 6.75; 95% CI, 1.34-33.81), morbidity and mortality in diabetics with an ABI of < or = 0.90. CONCLUSIONS: The type 2 diabetics with PAD present with a higher morbidity and mortality. The ABI is a good predictor of cardiovascular disease and heart failure morbidity and mortality.
Authors: María Teresa Alzamora; José Miguel Baena-Díez; Marta Sorribes; Rosa Forés; Pere Toran; Marisa Vicheto; Guillem Pera; María Dolores Reina; Carlos Albaladejo; Judith Llussà; Magda Bundó; Amparo Sancho; Antonio Heras; Joan Rubiés; Juan Francisco Arenillas Journal: BMC Public Health Date: 2007-12-11 Impact factor: 3.295