Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2011;64:186-92 - Vol. 64 Num.03 DOI: 10.1016/j.rec.2010.10.024

Ankle-Brachial Index Improves the Classification of Cardiovascular Risk: PERART/ARTPER Study

José M. Baena-Díez a,b,, María T. Alzamora c,d,e, Rosa Forés d, Guillem Pera e, Pere Torán e, Marta Sorribes f

a Instituto de Investigación en Atención Primaria (IDIAP) Jordi Gol, Institut Català de la Salut, Barcelona, Spain
b Centro de Salud La Marina, Institut Català de la Salut, Barcelona, Spain
c Departamento de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain
d Centro de Salud Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet, Barcelona, Spain
e Unitat de Recerca Metropolitana Nord, Institut Català de la Salut, Mataró, Barcelona, Spain
f Centro de Salud Sants, Institut Català de la Salut, Barcelona, Spain

Refers to

Vascular Risk, Diabetes and the Ankle-Brachial Index
Pedro Valdivielso, José Mancera-Romero, Miguel Angel Sánchez-Chaparro
Rev Esp Cardiol. 2011;64:729
Full text - PDF

Keywords

Ankle-brachial index. Coronary heart disease risk functions. Reclassification measures. Peripheral arterial disease.

Abstract

Introduction and objectives

The sensitivity of cardiovascular risk functions is low because many cardiovascular events occur in low- or intermediate-risk patients. The aim of the present study was to evaluate how the ankle-brachial index (ABI) reclassifies these patients.

Methods

We conducted a descriptive, transversal, multicenter study (28 centers) of 3171 randomly selected patients aged >49 years. We studied demographic variables, clinical history and cardiovascular risk factors, ABI (defined as pathologic if <0.9) and 10-year cardiovascular risk with the Framingham-Wilson, REGICOR and SCORE equations, dividing risk into three categories: low (Framingham<10%, REGICOR<5% and SCORE<2.5%, intermediate (10-19.9%, 5-9.9% and 2.5-4.9%, respectively) and high (≥20%, ≥10% and ≥5%, respectively). Low- or intermediate-risk patients were reclassified as high-risk if they presented ABI<0.9.

Results

We compared patients with ABI<0.9 and patients with ABI ≥0.9 and found the former were significantly older, more frequently men, had a worse history and more cardiovascular risk factors, and included more high-risk patients than when the classification used Framingham-Wilson (42.7% vs. 18.5%), REGICOR (25.8% vs. 9.3%) and SCORE (42.2% vs. 15.9%) equations. In men, using ABI led to a 5.8% increase in the high-risk category versus Framingham-Wilson, a 19.1% increase versus REGICOR and a 4.4% increase versus SCORE. In women, the increases were 78.6% versus Framingham-Wilson, 151.6% versus REGICOR and 50.0% versus SCORE.

Conclusions

The ABI reclassifies a substantial proportion of patients towards the high-risk category. This is particularly marked in women and by comparison with REGICOR scores.

1885-5857/© 2011 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

Cookies
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.
Cookies policy
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.