Ankle-brachial index as a predictor of coronary disease events in elderly patients submitted to coronary angiography
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2013-01-01
Autores
Papa, Eduardo D. E. [UNIFESP]
Helber, Izo [UNIFESP]
Ehrlichmann, Manes R.
Rodrigues Alves, Claudia Maria [UNIFESP]
Makdisse, Marcia
Matos, Livia N. [UNIFESP]
Borges, Jairo Lins [UNIFESP]
Lopes, Renato D.
Stefanini, Edson [UNIFESP]
Carvalho, Antonio Carlos [UNIFESP]
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OBJECTIVES: To correlate the importance of the ankle-brachial index in terms of cardiovascular morbimortality and the extent of coronary arterial disease amongst elderly patients without clinical manifestations of lower limb peripheral arterial disease.METHODS: We analyzed prospective data from 100 patients over 65 years of age with coronary arterial disease, as confirmed by coronary angiography, and with over 70% stenosis of at least one sub-epicardial coronary artery. We measured the ankle-brachial index immediately after coronary angiography, and a value of <0.9 was used to diagnose peripheral arterial disease.RESULTS: the patients' average age was 77.4 years. the most prevalent risk factor was hypertension (96%), and the median late follow-up appointment was 28.9 months. the ankle-brachial index was <0.9 in 47% of the patients, and a low index was more prevalent in patients with multiarterial coronary disease compared to patients with uniarterial disease in the same group. Using a bivariate analysis, only an ankle-brachial index of,0.9 was a strong predictive factor for cardiovascular events, thereby increasing all-cause deaths and fatal and non-fatal acute myocardial infarctions two-to three-fold.CONCLUSION: in elderly patients with documented coronary disease, a low ankle-brachial index (<0.9) was associated with the severity and extent of coronary arterial disease, and in late follow-up appointments, a low index was correlated with an increase in the occurrence of major cardiovascular events.
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Clinics. São Paulo: Hospital Clinicas, Univ São Paulo, v. 68, n. 12, p. 1481-1487, 2013.