INTRODUCTION AND OBJECTIVES: The presence of peripheral arterial disease in patients with coronary artery disease is associated with a poor cardiovascular outcome. However, the majority of affected patients are asymptomatic and the condition is underdiagnosed. The ankle-brachial index (ABI) provides a simple method of diagnosis. The aim of this study was to assess the usefulness of an abnormal ABI for identifying multivessel coronary artery disease in patients with acute coronary syndrome (ACS). METHODS: We analyzed data on all ACS patients included in the PAMISCA multicenter study (with 94 participating hospitals) who underwent catheterization during admission. Patients were diagnosed with multivessel coronary disease if two or more major epicardial vessels or the left main coronary artery, or both, were affected. An ABI <or=0.9 or >1.4 was considered abnormal. RESULTS: The study included 1031 patients with a mean age of 67.7 years. Of these, 542 had multivessel disease (52.6%). Compare with those without multivessel disease, these patients were older (66.6 years vs. 62.6 years; P< .001), had higher prevalences of hypertension (65.9% vs. 56.2%; P< .005), diabetes mellitus (40.6% vs. 26.0%; P< .001) and hypercholesterolemia (89.1% vs. 80.4%; P< .001), and were more likely to have a history of cardiovascular disease (30.1% vs. 13.9%; P< .001) or an abnormal ABI (45.4% vs. 30.3%; P< .001). Multivariate analysis showed that the presence of an abnormal ABI was associated with an increased risk of multivessel disease (odds ratio=1.58; 95% confidence interval, 1.16-2.15; P< .05). CONCLUSIONS: In patients with ACS, an abnormal ABI was independently associated with the risk of multivessel coronary artery disease.
INTRODUCTION AND OBJECTIVES: The presence of peripheral arterial disease in patients with coronary artery disease is associated with a poor cardiovascular outcome. However, the majority of affected patients are asymptomatic and the condition is underdiagnosed. The ankle-brachial index (ABI) provides a simple method of diagnosis. The aim of this study was to assess the usefulness of an abnormal ABI for identifying multivessel coronary artery disease in patients with acute coronary syndrome (ACS). METHODS: We analyzed data on all ACS patients included in the PAMISCA multicenter study (with 94 participating hospitals) who underwent catheterization during admission. Patients were diagnosed with multivessel coronary disease if two or more major epicardial vessels or the left main coronary artery, or both, were affected. An ABI <or=0.9 or >1.4 was considered abnormal. RESULTS: The study included 1031 patients with a mean age of 67.7 years. Of these, 542 had multivessel disease (52.6%). Compare with those without multivessel disease, these patients were older (66.6 years vs. 62.6 years; P< .001), had higher prevalences of hypertension (65.9% vs. 56.2%; P< .005), diabetes mellitus (40.6% vs. 26.0%; P< .001) and hypercholesterolemia (89.1% vs. 80.4%; P< .001), and were more likely to have a history of cardiovascular disease (30.1% vs. 13.9%; P< .001) or an abnormal ABI (45.4% vs. 30.3%; P< .001). Multivariate analysis showed that the presence of an abnormal ABI was associated with an increased risk of multivessel disease (odds ratio=1.58; 95% confidence interval, 1.16-2.15; P< .05). CONCLUSIONS: In patients with ACS, an abnormal ABI was independently associated with the risk of multivessel coronary artery disease.
Authors: Dinaldo Cavalcanti de Oliveira; Augusto Correia; Jose Nascimento Neto; Myrtson Gurgel; Filipe Wanick Sarinho; Edgar Guimares Victor Journal: Cardiol Res Date: 2015-02-09
Authors: Felipe José de Andrade Falcão; Cláudia Maria Rodrigues Alves; Adriano Caixeta; Leonardo de Freitas Guimarães; Juscélio Trajano de Sousa Filho; Juliana A Soares; Izo Helber; Antônio C Carvalho Journal: Clin Interv Aging Date: 2013-12-02 Impact factor: 4.458
Authors: Eduardo D E Papa; Izo Helber; Manes R Ehrlichmann; Claudia Maria Rodrigues Alves; Marcia Makdisse; Livia N Matos; Jairo Lins Borges; Renato D Lopes; Edson Stefanini; Antonio Carlos Carvalho Journal: Clinics (Sao Paulo) Date: 2013-12 Impact factor: 2.365