Ankle-brachial index as a predictor of coronary disease events in elderly patients submitted to coronary angiography

• Autor(a) principal: Papa, Eduardo D. E. [UNIFESP]
• Data de Publicação: 2013
• Outros Autores: 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]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://repositorio.unifesp.br/handle/11600/35765; http://dx.doi.org/10.6061/clinics/2013(12)02
• topic: Peripheral Artery Disease; Prognosis; Coronary artery Disease; Ankle Brachial Index; Elderly

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.