[Prevalence of asymptomatic peripheral artery disease detected by the ankle-brachial index in patients with cardiovascular disease. MERITO II study].
OBJECTIVE
Patients with polyvascular disease have an increased rate of cardiovascular events and death. Their identification would define a subgroup of the population at very high risk, who would be candidates to intensified preventive measures. The objective of the present study was to evaluate the prevalence of subclinical peripheral artery disease in subjects with a previous diagnosis of vascular disease in other territories.


METHODS
Subjects with a coronary or a cerebrovascular event between 3 months and 5 years, and who were attended at internal medicine outpatient clinics from Spain were included in the study. All patients had a clinical history, a physical examination, a blood and urine analysis, and a measurement of the ankle-brachial index (ABI).


RESULTS
A total of 1203 patients (64% males; mean age: 74.3 years), were included in the study. A previous coronary event was reported in 55.4% of the participants, cerebrovascular disease in 38%, and a clinical history of disease in both territories in 6.7%. The prevalence of a low ABI (< 0,9) was 33.8%, 32.4% and 53.9% for each group, respectively. In a multivariate analysis, factors associated with a low ABI were age, smoking habit, diabetes, a reduced glomerular filtration rate, systolic blood pressure and the presence of clinical disease in both territories upon inclusion. The sensitivity of both, the Edinburgh questionnaire and pulse palpation for detecting and ABI below 0.9, were low.


CONCLUSIONS
Prevalence of a low ABI is elevated in asymptomatic patients with coronary or cerebrovascular disease, particularly if there are clinical manifestations in both territories.
Mostaza
José M
JM
Unidad de Arteriosclerosis. Servicio de Medicina Interna. Hospital Carlos III. Madrid. España. jmostaza.hciii@salud.madrid.org
Manzano
Luis
L
Suárez
Carmen
C
Cairols
Marc
M
Ferreira
Eva María
EM
Rovira
Eduardo
E
Sánchez
Aquilino
A
Suárez-Tembra
Manuel A
MA
Estirado
Eva
E
Estrella
Juan de Dios
Jde D
Vega
Francisco
F
Sánchez-Zamorano
Miguel Angel
MA
D000368:Aged; D055109:Ankle Brachial Index; D002318:Cardiovascular Diseases / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies