Prevalence and risk factors of PAD among patients with elevated ABI
Prevalence and risk factors of PAD among patients with elevated ABI
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DOI：
10.1016/j.ejvs.2008.01.013
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发表时间：
2008-06-01
影响因子：
5.7
通讯作者：
Salenius, J.
中科院分区：
文献类型：
--
作者：
Suominen, V.;Rantanen, T.;Salenius, J.
目标.评估血管会诊患者踝臂指数（ABI）升高的患病率和临床意义。回顾性临床研究。材料和方法。在1，762名疑似外周动脉疾病（PAD）的患者中，通过光电体积描记术测量ABI和总肱指数（TBI）。ABI ≥ 1.3为假性升高，TBI < 0.60为PAD的诊断标准。ABI升高的发生率为8.4%，PAD的发生率为62.2%。PAD在有严重症状（静息痛、溃疡或坏疽）的受试者中的患病率明显高于间歇性疼痛的受试者。跛行（分别为83.8%和45.3%，P < 0.001）。在慢性肾功能衰竭患者中，PAD诊断风险为10倍（OR 10.31，95% CI 2.07-51.30），在有吸烟史的患者中为5倍（OR 5.63，95% CI 1.22-26.00），在冠心病患者中超过3倍（OR 3.44，95% CI 1.46-8.12）。ABI阈值升高（1.3、1.4和1.5）诊断PAD的特异性分别为86%、94%和96%，敏感性分别为44%、38%和36%。血管会诊患者中ABI升高的患病率为8.4%，其中PAD的患病率为62.2%。PAD在慢性肾衰竭、吸烟史和冠心病患者中的可能性更大。此外，ABI升高（> 1.3）识别PAD的特异性良好，而敏感性仅令人满意。(c)2008年欧洲血管外科学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives. To assess the prevalence and clinical significance of elevated ankle-brachial index (ABI) in patients referred to vascular consultation.Design. Retrospective clinical study.Material and methods. In 1,762 patients referred with a suspicion of peripheral arterial disease (PAD), ABI and tot, brachial index (TBI) were measured by photoplethysmography. ABI >= 1.3 was considered falsely elevated and TBI < 0.60 was the diagnostic criterion for PAD.Results. The prevalence of elevated ABI was 8.4% and that of PAD among these patients 62.2%. PAD was significantly more prevalent among subjects with severe symptoms (rest pain, ulcers or gangrene) than in those with intermittent. claudication (83.8% and 45.3%, respectively, p < 0.001). The risk of PAD diagnosis was ten-fold (OR 10.31, 95% CI 2.07-51.30) among those with chronic renal failure, five-fold among patients with a history of smoking (OR 5.63, 95% CI 1.22-26.00) and over three-fold (OR 3.44, 95% CI 1.46-8.12) among those with coronary heart disease. The specificities of elevated ABI threshold levels (1.3, 1.4 and 1.5) in identifying PAD were 86%, 94% and 96%, respectively, the sensitivities being 44%, 38% and 36%, respectively.Conclusions. The prevalence of elevated ABI in patients referred to vascular consultation is 8.4% and that of PAD among these 62.2%. PAD is significantly more probable among those with chronic renal failure, a history of smoking and coronary heart disease. Furthermore, the specificity of elevated ABI (> 1.3) in recognizing PAD is good, whereas the sensitivity is only satisfactory. (c) 2008 European Sociely for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.