Associations of ankle-brachial index with clinical coronary heart disease, stroke and preclinical carotid and popliteal atherosclerosis: The atherosclerosis risk in communities (ARIC) study
Associations of ankle-brachial index with clinical coronary heart disease, stroke and preclinical carotid and popliteal atherosclerosis: The atherosclerosis risk in communities (ARIC) study
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DOI：
10.1016/s0021-9150(97)06089-9
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发表时间：
1997-05-01
期刊：
影响因子：
5.3
通讯作者：
Heiss, G
中科院分区：
文献类型：
--
作者：
Zheng, ZJ;Sharrett, AR;Heiss, G
静息踝臂指数(ABI)是一种非侵入性的方法，可以评估下肢动脉系统的通畅性，并筛查是否存在外周闭塞性动脉疾病。为了确定ABI与临床冠心病、卒中、临床前颈动脉斑块以及颈动脉和月国动脉的远壁内中膜厚度的关系，我们从社区动脉粥样硬化风险研究的基线检查(1987年-)开始，对15106名中年人进行了分析。临床冠心病、中风/短暂性脑缺血发作(TIA)和临床前颈动脉斑块的患病率随着ABI水平的降低而增加，尤其是所有这些水平。ABI<；0.90携带者罹患冠心病的可能性是ABI>；0.90携带者的两倍(年龄调整后的优势比(OR)从非裔美国男性的2.2(95%可信区间：1.0-5.1)到白人男性的3.3(95%可信区间：2.1-5.0))。ABI<；0.90携带者患中风/短暂性脑缺血发作的可能性是ABI>；0.90携带者的四倍多(年龄调整后的OR：非裔美国人为4.2(95%CI：1.8-9.5)，白人男性为4.9(95%CI：2.6-9.0))。在女性中，这种联系较弱，在统计学上没有显著意义。在那些没有临床心血管疾病的人中，ABI小于或等于0.90的个体的临床前颈动脉斑块患病率显著高于ABI>；0.90的个体(年龄调整后的OR从白人女性的1.5(95%可信区间：1.0-1.9)到非裔美国男性的2.6(95%可信区间：1.06.6))。ABI还与颈动脉(男性和女性)和月国动脉(仅男性)的远壁IMT呈负相关。ABI与临床冠心病、中风、临床前颈动脉斑块以及颈动脉和月国动脉IMT的相关性减弱，在进一步调整低密度脂蛋白、吸烟、高血压和糖尿病后往往没有统计学意义。这些数据表明，低的ABI水平，特别是0.90的ABI水平，是全身动脉粥样硬化的标志。(C)1997年爱思唯尔爱尔兰科学有限公司。
The resting ankle-brachial index (ABI) is a non-invasive method to assess the patency of the lower extremity arterial system and to screen for the presence of peripheral occlusive arterial disease. To determine how the ABI is associated with clinical coronary heart disease (CHD), stroke, preclinical carotid plaque and far wall intimal-medial thickness (IMT) of the carotid and popliteal arteries, we conducted analyses in 15 106 middle-aged adults from the baseline examination (1987-1989) of the Atherosclerosis Risk in Communities (ARIC) Study. The prevalence of clinical CHD, stroke/transient ischemic attack (TIA) and preclinical carotid plaque increased with decreasing ABI levels, particularly al those of < 0.90. Individuals with ABI < 0.90 were twice as likely to have prevalent CHD as those with ABI > 0.90 (age-adjusted odds ratio (OR) ranging from 2.2 (95% CI: 1.0-5.1) in African-American men to 3.3 (95% CI: 2.1-5.0) in white men). Men with ABI < 0.90 were more than four times as likely to have stroke/TIA as those with ABI > 0.90 (age-adjusted OR: 4.2 (95% CI: 1.8-9.5) in African-American men and 4.9 (95% CI: 2.6-9.0) in white men). In women the association was weaker and not statistically significant. Among those free of clinical cardiovascular disease, individuals with ABI less than or equal to 0.90 had statistically significantly higher prevalence of preclinical carotid plaque compared to those with ABI > 0.90 (age-adjusted ORs ranging from 1.5 (95% CI: 1.0-1.9) in white women to 2.6 (95% CI: 1.06.6) in african-american men). The ABI was also inversely associated with far wall IMT of the carotid arteries (in both men and women) and the popliteal arteries (in men only). The associations of ABI with clinical CHD, stroke, preclinical carotid plaque and IMT of the carotid and popliteal arteries were attenuated and often not statistically significant after further adjustment for LDL cholesterol, cigarette smoking, hypertension and diabetes. These data demonstrate that low ABI levels, particularly those of < 0.90, are indicative of generalized atherosclerosis. (C) 1997 Elsevier Science Ireland Ltd.