Prevalence of carotid stenosis and silent myocardial ischemia in asymptomatic subjects with a low ankle-brachial index

Abstract

Our results indicate that in high-risk asymptomatic subjects >60 years of age, the presence of an ABI <0.9 identifies a subgroup of the population with an increased prevalence of carotid stenosis and of silent myocardial ischemia and, as such, are candidates for closer follow-up.

Associations Between Peripheral Artery Disease and Ischemic Stroke

“…In addition, carotid stenosis is more prevalent in asymptomatic patients with PAD than patients with a normal ABI. 29 Compared with symptomatic unilateral carotid stenosis, symptomatic bilateral carotid stenosis was associated with nonstroke vascular death (hazard ratioϭ2.0; 1.5 to Figure 2. Age-specific event rates for nonfatal acute vascular events in a population-based study (OXVASC).…”

“…Это позволило предположить, что ЗПА являются более значимым предиктором риска развития инсульта, чем ИБС. Кроме того, стеноз сонных артерий более широко распространен среди пациентов с бессимптомны-ми ЗПА по сравнению с пациентами с нормальным ЛПИ [29]. В испытании European Carotid Surgery Trial двусторонний симптомный стеноз сонных артерий по сравнению с односторонним симптомным стено-зом сонных артерий был ассоциирован с повышенной летальностью от сосудистого заболевания, не связан-ного с инсультом (отношение шансов [ОШ]=2,0; 95% доверительный интервал [ДИ] от 1,5 до 2,6) и пред-шествующим ЗПА (ОШ=1,5; 95% ДИ от 1,2 до 2,0), что также отражает вклад системного заболевания [30].…”

Carotid artery disease and stroke in patients with peripheral arterial disease. The role of inflammation

“…Consistent with the latter finding are the results of the Cardiovascular Health Study (CHS) [18] which showed that the relative risk for moderate (50%-74%) and se-vere (75%-100%) carotid stenoses increased in a graded stepwise fashion as the ABI decreased. Mostaza Jose M. et al [19] reported that it was 14.3% in PAD patients and only 4.7% in the control subjects, matched for age, sex, and major risk factors. Similarly, in our experience, the presence of > 50% carotid stenosis in PAD was 18.6% [20].…”

“…On the contrary, less is known about the implications of the presence of carotid disease in PAD [17][18][19][20][21][22][23]. This is particularly unfortunate, because PAD affects about 27 million of persons in western countries and carotid disease is the principal cause of ischemic cerebrovascular events, which have an important socioeconomic impact, representing a main cause of disability and a relevant financial burden in terms of direct and indirect costs.…”

The Ankle-Brachial Index is Associated With Cardiovascular Complications After Noncardiac Surgery

“…12 It also provides important information for quantifying cardiovascular risk, even in asymptomatic patients, especially when associated with Framinghan risk score. 13,14 It is inexpensive, fast, and can be used in the outpatient clinic, with a good acceptance by patients and small intra and interobserver variation. [15][16][17] However, it has not been widely evaluated in the perioperative setting to date.…”