THE RATIO OF ANKLE AND ARM ARTERIAL-PRESSURE AS AN INDEPENDENT PREDICTOR OF MORTALITY
THE RATIO OF ANKLE AND ARM ARTERIAL-PRESSURE AS AN INDEPENDENT PREDICTOR OF MORTALITY
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DOI：
10.1016/0021-9150(91)90014-t
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发表时间：
1991-04-01
期刊：
影响因子：
5.3
通讯作者：
KULLER, L
中科院分区：
文献类型：
--
作者：
MCKENNA, M;WOLFSON, S;KULLER, L
我们仔细确定了744名患者的死亡情况，这些患者在一所大学附属的社区医院接受了下肢外周动脉疾病(PAD)的非侵入性检测。以踝部和臂部血压比值小于0.85为标准，在比例风险模型中调整基线协变量后，与PAD相关的总死亡率的相对危险度(RR)为2.36(95%CL=1.60，3.48)。有一个强烈的趋势是，随着ABI的降低，风险增加(P<；0.0001)。存活率与ABI的大小直接相关的特定死亡原因是心肌梗塞，以及血管疾病和癌症以外的死亡。ABI与癌症死亡风险之间没有关系。ABI正常者的死亡经历与美国普通人群非常相似(年龄调整后RR=1.14，95%CL=0.78，1.61)，而ABI<0.4者的风险显著高于美国人群(RR=4.49，95%CL=3.52，5.64)。我们的结果表明，技术上相对简单的测量踝臂血压比的方法，如果很低，预后非常差，应该会促使对其他血管系统的动脉粥样硬化性疾病进行研究和治疗。
We carefully ascertained deaths for a cohort of 744 patients who had undergone noninvasive testing for lower extremity peripheral arterial disease (PAD) in a university affiliated, community hospital. Using a ratio of the ankle and brachial blood pressures (ABI) of less than 0.85 as the criteria, the relative risk (RR) for total mortality associated with PAD was 2.36 (95% CL = 1.60, 3.48) after adjusting for baseline covariates in a proportional hazards model. There was a strong trend for increasing risk with decreasing ABI (P < 0.0001). Specific causes of death for which survival was directly related to the magnitude of ABI were myocardial infarctions, and deaths other than vascular disease and cancer. There was no relationship between ABI and the risk of mortality from cancer. The mortality experience of those with normal ABI was very similar to that of the general U.S. population (age adjusted RR = 1.14, 95% CL = 0.78, 1.61), whereas the risk for those with an ABI less than 0.4 was markedly elevated in comparison to the U.S. population (RR = 4.49, 95% CL = 3.52, 5.64). Our results suggest that the relatively technically simple measure of the ratio of ankle to brachial blood pressures, if low, carries a very poor prognosis and should prompt investigation and treatment of atherosclerotic disease in other vascular systems.