title: [Prevalence of asymptomatic peripheral artery disease detected by the ankle-brachial index in patients with cardiovascular disease. MERITO II study].
abstract: 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.
authors.affiliation: Unidad de Arteriosclerosis. Servicio de Medicina Interna. Hospital Carlos III. Madrid. España. jmostaza.hciii@salud.madrid.org
authors.forename: José M
authors.initials: JM
authors.lastname: Mostaza
authors.forename: Luis
authors.initials: L
authors.lastname: Manzano
authors.forename: Carmen
authors.initials: C
authors.lastname: Suárez
authors.forename: Marc
authors.initials: M
authors.lastname: Cairols
authors.forename: Eva María
authors.initials: EM
authors.lastname: Ferreira
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rovira
authors.forename: Aquilino
authors.initials: A
authors.lastname: Sánchez
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Suárez-Tembra
authors.forename: Eva
authors.initials: E
authors.lastname: Estirado
authors.forename: Juan de Dios
authors.initials: Jde D
authors.lastname: Estrella
authors.forename: Francisco
authors.initials: F
authors.lastname: Vega
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Sánchez-Zamorano
mesh_terms: 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