Is the ankle-brachial index a useful screening test for subclinical atherosclerosis in asymptomatic, middle-aged adults?

Is the ankle-brachial index a useful screening test for subclinical atherosclerosis in asymptomatic, middle-aged adults?
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发表时间：
2006-09
期刊：
WMJ : official publication of the State Medical Society of Wisconsin
影响因子：
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通讯作者：
Rachael A. Wyman;J. Keevil;Kjersten L Busse;S. Aeschlimann;C. Korcarz;J. Stein
Rachael A. Wyman;J. Keevil;Kjersten L Busse;S. Aeschlimann;C. Korcarz;J. Stein
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文献类型：
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作者：
Rachael A. Wyman;J. Keevil;Kjersten L Busse;S. Aeschlimann;C. Korcarz;J. Stein

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踝臂指数（ABI）的测量被推荐作为≥ 50岁人群心血管风险预测的筛查试验;然而，关于ABI作为筛查试验在医生实际要求进行心血管风险预测的非侵入性试验的人群中的实用性的数据很少。方法：本研究包括493例无症状的无已知动脉粥样硬化性血管疾病的患者，由他们的医生推荐测量ABI和超声测量颈动脉内膜中层厚度（CIMT）。ABI值被归类为“降低”（1.3）。结果患者的平均年龄为55.3岁（标准差7.5）。仅1例患者ABI降低（0.2%）。CIMT增高组ABI值有增高趋势（P=0.051），而ABI正常组和CIMT增高组CIMT无显著性差异（P=0.802）。ABI组之间传统心血管危险因素的患病率或颈动脉斑块的存在没有显著差异。结论：尽管有推荐，但ABI作为无症状中年人亚临床动脉粥样硬化的筛查工具并不敏感。
BACKGROUND Measurement of the ankle-brachial index (ABI) is recommended as a screening test for cardiovascular risk prediction in individuals > or = 50 years old; however, there is little data regarding the utility of the ABI as a screening test in individuals for whom physicians actually order non-invasive testing for cardiovascular risk prediction. METHODS This study included 493 consecutive asymptomatic patients without known atherosclerotic vascular disease who were referred by their physician for measurement of the ABI and ultrasound measurement of carotid intima-media thickness (CIMT). ABI values were classified as "reduced" (1.3). RESULTS The mean age of the patients was 55.3 (standard deviation 7.5) years. Only 1 patient had a reduced ABI (0.2%). ABI values tended to be higher in those with increased CIMT (P=0.051); however, CIMT was not significantly different between those with normal and increased ABI values (P=0.802). There were no significant differences in the prevalence of traditional cardiovascular risk factors or carotid plaque presence among the ABI groups. CONCLUSIONS Despite recommendations, the ABI is not sensitive as a screening tool for detecting subclinical atherosclerosis in asymptomatic middle-aged individuals.