The ankle-brachial index in the elderly and risk of stroke, coronary disease, and death - The Framingham study
The ankle-brachial index in the elderly and risk of stroke, coronary disease, and death - The Framingham study
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DOI：
10.1001/archinte.163.16.1939
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发表时间：
2003-09-08
影响因子：
--
通讯作者：
Wilson, PWF
中科院分区：
文献类型：
--
作者：
Murabito, JM;Evans, JC;Wilson, PWF
背景：低踝臂指数（ABI）与死亡和心血管疾病风险增加相关。关于低ABI和中风之间的关系，存在有限的数据。我们试图研究一个低ABI和中风，冠心病和死亡之间的关系在elderization.Methods：我们检查了251名男性和423名女性，平均年龄为80岁，1994年至1995年有一个Fracket研究检查。低ABI定义为小于0.9。随访4年，观察中风或短暂性脑缺血发作、冠心病和死亡的发生情况。考克斯比例风险模型被用来评估调整年龄，性别和流行的心血管疾病后，一个低ABI和每个结果之间的关系：一个低ABI检测到20%的样本只有18%的参与者与低ABI报告跛行症状。三分之一的ABI正常的人和55%的ABI低的人在基线时患有心血管疾病。多变量考克斯比例风险分析结果表明，低ABI患者卒中或短暂性脑缺血发作的风险在统计学上显著增加（风险比，2.0; 95%置信区间，1.1-3.7）。低ABI和冠心病（危险比，1.2; 95%可信区间，0.7-2.1）或死亡（危险比，1.4; 95%可信区间，0.9-2.1）之间没有显着关系observed.Conclusions：低ABI与老年人中风或短暂性脑缺血发作的风险有关。这些结果需要在更大规模的研究中得到证实。
Background: A low ankle-brachial index (ABI) is associated with an increased risk of death and cardiovascular disease. Limited data exist regarding the relation between a low ABI and stroke. We sought to examine the relation between a low ABI and stroke, coronary heart disease, and death in the elderly.Methods: We examined 251 men and 423 women with a mean age of 80 years who had a Framingham Study examination from 1994 to 1995. A low ABI was defined as less than 0.9. Persons were followed up for 4 years for occurrence of stroke or transient ischemic attack, coronary disease, and death. Cox proportional hazards models were used to assess the relation between a low ABI and each outcome after adjusting for age, sex, and prevalent cardiovascular disease.Results: A low ABI was detected in 20% of our sample Only 18% of the participants with a low ABI reported claudication symptoms. One third of those with a normal ABI and 55% of those with a low ABI had cardiovascular disease at baseline. Results of multivariable Cox proportional hazards analysis demonstrated a statistically significant increase in the risk of stroke or transient ischemic attack in persons with a low ABI (hazards ratio, 2.0; 95% confidence interval, 1.1-3.7). No significant relation between a low ABI and coronary heart disease (hazards ratio, 1.2; 95% confidence interval, 0.7-2.1) or death (hazards ratio, 1.4; 95% confidence interval, 0.9-2.1) was observed.Conclusions: A low ABI is associated with risk of stroke or transient ischemic attack in the elderly. These results need to be confirmed in larger studies.