scholarly journals Prevalence of Lower Extremity Arterial Disease as Measured by Low Ankle-Brachial Index in Patients with Acute Cerebral Ischemic Events

2020 ◽  
Vol 9 (10) ◽  
pp. 3265
Author(s):  
Magdalena Konieczna-Brazis ◽  
Paweł Sokal ◽  
Paweł Brazis ◽  
Tomasz Grzela ◽  
Milena Świtońska ◽  
...  

Background: Low ankle–brachial index (ABI) of ≤0.9 is diagnostic of lower extremity arterial disease (LEAD). It is also a strong marker of generalized atherosclerosis. The objective of this study was to assess the prevalence of low ABI in patients with acute cerebral ischemic events (ACIE): ischemic stroke (IS) or transient ischemic attack (TIA). Methods: We compared 150 inpatients with ACIE to 50 inpatient controls and assessed risk factors, ABI measurements, and Duplex ultrasound of the cervical vessels. Results: Low ABI was seen in 69 patients (46%) in the ACIE group and in 8 (16%) in the control group; p < 0.01. The mean and median ABI values in the ACIE group were 0.88 (SD = 0.22) and 0.91 (0.24–1.33), which were significantly lower than in the control group: 1.04 (SD = 0.16) and 1.0 (0.66–1.36); p < 0.0001, respectively. Coronary artery disease, carotid stenosis of ≥50% and smoking were risk factors, which were associated with significantly lower ABI in the study group; the ABI with risk factors vs. without was 0.85 vs. 0.92 (coronary artery disease); p < 0.05, 0.7 vs. 0.92; (carotid stenosis) p < 0.001 and 0.83 vs. 0.98; (smoking) p < 0.001, respectively. Conclusion: Our study demonstrated that patients with ACIE have significantly higher involvement of another vascular bed as LEAD. Coronary artery disease, carotid stenosis ≥50% and smoking were main risk factors associated with coexistence of LEAD and ACIE.

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Saumen Nandi ◽  
Anindya Mukherjee ◽  
Dibbendhu Khanra ◽  
Kaushik Biswas

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s43044-020-00091-z.


2017 ◽  
Vol 11 (2) ◽  
pp. 79-84
Author(s):  
Syed Dawood Md Taimur ◽  
Mashhud Zia Chowdhury ◽  
Md Enamul Hakim

Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown.Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between presence of PAD and severity of CAD. Material &Methods: This five years retrospective study was conducted at invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, severity of coronary artery and peripheral artery disease.Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension were detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 88.3% and 58.4% had positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients 52 had both coronary and peripheral arterial disease which was statistically significant (p<.014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. Peripheral angiogram revealed 51.9% had superficial femoral artery disease, 24.7% had anterior tibial artery disease, 26% had posterior tibial artery disease, 15.6% had common iliac artery and common femoral artery disease and 2.6% had renal artery disease.Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.University Heart Journal Vol. 11, No. 2, July 2015; 79-84


1993 ◽  
Vol 39 (2) ◽  
pp. 209-212 ◽  
Author(s):  
J H Wu ◽  
J T Kao ◽  
M S Wen ◽  
D Wu

Abstract We measured lipid and lipoprotein concentrations in blood samples from control subjects and patients with coronary artery disease (CAD) in Taiwan. We found significant differences (P &lt; 0.01) in the concentrations of high-density lipoprotein cholesterol (HDLC), apolipoprotein AI (ApoAI), apolipoprotein B (ApoB), and lipoprotein(a) [Lp(a)]. Concentrations of HDLC &lt; 350 mg/L, ApoAI &lt; 900 mg/L, ApoB &gt; 800 mg/L, and Lp(a) &gt; 200 mg/L occurred, respectively, 2.8, 5.2, 1.7, and 2.3 times more frequently in the patients than in the control group. If one considers HDLC at &lt; 350 mg/L, ApoAI at &lt; 900 mg/L, ApoB at &gt; 800 mg/L, and Lp(a) at &gt; 200 mg/L as separate risk factors for CAD, the ratio of individual patients to control subjects having 4, 3, 2, 1, or 0 risk factors was [symbol: see text] 9.4, 2.1, 0.2, 0.2, respectively. Individuals displaying three or more risk factors were found 15 times more frequently in the CAD group than in the control group. These risk factors may be used clinically for the prediction and prevention of CAD in the general population.


2009 ◽  
Vol 36 (11) ◽  
pp. 2454-2461 ◽  
Author(s):  
ROBERT J. GOLDBERG ◽  
MURRAY B. UROWITZ ◽  
DOMINIQUE IBAÑEZ ◽  
MANDANA NIKPOUR ◽  
DAFNA D. GLADMAN

Objective.To ascertain coronary artery disease (CAD) outcomes and predictive factors in a prospective study of patients with systemic lupus erythematosus (SLE) and matched healthy controls.Methods.SLE patients and non-SLE age-matched controls without a history of CAD were recruited into a prospective study between 1997 and 1999. CAD events were assessed at clinic visit for SLE patients and through telephone interview and chart review for controls. All events were verified with patient medical records.Results.Followup information was available on 237 controls and 241 SLE patients. The mean followup time was 7.2 years. Univariate analyses identified age and postmenopausal status as predictors of CAD in both the groups. Sedentary lifestyle, hypertension, the presence of metabolic syndrome, and the number of Framingham risk factors were predictive in the control group only. The 10-year risk of CAD score was predictive in both groups but was not as marked in the SLE group as in the controls. None of the lipid subfractions were predictive for CAD in the SLE group, whereas in the controls, a high triglyceride level ≥ 2.8 was predictive. Time-to-event multivariate analysis for CAD in all subjects revealed SLE itself, older age, and triglycerides ≥ 2.8 to be highly predictive for CAD.Conclusion.In a prospective study of patients with SLE and matched controls followed over a median of 8 years, patients with SLE developed significantly more CAD events than controls. Accounting for demographic variability, CAD risk factors, and lipid factors, SLE is an independent risk factor for the development of CAD.


2020 ◽  
Vol 66 (4) ◽  
pp. 407-413
Author(s):  
Saulo Henrique Salgueiro de Aquino ◽  
Isabelle Tenório Melo ◽  
Carlos Dornels Freire de Souza ◽  
Francisco de Assis Costa

SUMMARY OBJECTIVE Analyzing the association between ABI and the main risk factors for coronary artery disease in coronary patients. METHODS Were selected 156 adult patients from a hospital in Maceió, Alagoas. Were evaluated with risk factors age, obesity, hypertension, diabetes mellitus, smoking, and dyslipidemia. PAOD screening was performed by the ankle-brachial index (ABI). The Mann-Whitney, chi-square, and Fisher’s exact tests were used. Confidence Interval of 95% and a significance of 5%. RESULTS 67.3% (n=105) males, 52.6% (n=82) elderly, 23.1% (n = 34) obese, 72.4% 6% (n=113) hypertensive, 34.6% (n=54) diabetics, 53.2% (n=83) smokers, 34.6% (n=54) dyslipidemic and 70.5% (n=110) with a family history of CAD. 16.7% (n=26) of the individuals presented PAOD. Three factors were associated with PAOD: age group ≥ 60 years (OR:3.656; p=0.005), diabetes mellitus (OR:2.625; p=0.024) and hypertension (OR:5.528; p=0.008). No significant difference was observed in the variables smoking, dyslipidemia, family history of CAD, and obesity. CONCLUSION The independent risk factors for PAOD were age, diabetes mellitus, and systemic arterial hypertension.


e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Jacqueline A. Fuzairi ◽  
Dewi U. Djafar ◽  
Agnes L. Panda

Abstract: Cardiovascular disease is a huge burden in terms of mortality, disability, and morbidity in this day. Prevention of cardiovascular disease is based on the physical signs. Waist circumference, Ankle Brachial Index (ABI) and Carotid Intima Media Thickness (CIMT) are useful to recognize occult atherosclerosis, so as ear lobe crease. However, medics have less attention about examination of ear lobe crease for detection of coronary artery disease. This study aimed to determine the relation of ear lobe crease and coronary artery disease. This was an analytical observational study with a case control design. The results showed that there were 45 samples for control group and 45 samples for case group. The statistical analysis showed the X2 = 21.78 with a p value <0,001 which indicated that there was a significant correlation between Ear Lobe Crease and Coronary Artery Disease. The OR = 8.9% (95% CI 3.4 -23.3) meant that if a person had ear lobe crease, the possibility of coronary artery disease was 8.9 times higher than a person without ELC. Conclusion: There was a significant correlation between Ear Lobe Crease and Coronary Artery Disease.Keywords: ear lobe crease, coronary artery diseaseAbstrak: Penyakit Kardiovaskular merupakan penyebab utama kematian, kecacatan dan kesakitan saat ini. Deteksi penyakit kardiovaskular sebagai tindakan pencegahan dapat dilihat melalui pemeriksaan fisik. Pengukuran lingkar pinggang, Ankle Brachial Index (ABI), dan Carotid Intima Media Thickness (CIMT) sangat berguna untuk penanda aterosklerosis subklinis, begitu pula dengan Ear Lobe Crease. Namun sampai saat ini, pemeriksaan Ear Lobe Crease untuk menilai penyakit jantung koroner kurang mendapat perhatian petugas medis. Tujuan penelitian ini adalah untuk mengetahui apakah terdapat hubungan antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner. Metode: Penelitian ini dilakukan menggunakan metode penelitian analitik observasional dengan case control. Hasil penelitian: Sampel penelitian terdiri dari 45 orang untuk kelompok kontrol dan 45 orang untuk kelompok kasus. Berdasarkan uji X2 diperoleh X2 = 21,78 dengan p < 0,001. Hasil ini menunjukkan bahwa adanya hubungan yang sangat bermakna antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner (p < 0,001). Dalam uji ini, juga diperoleh OR = 8,9 (95% CI: 3,4 – 23,3). Odd Ratio (OR) ini menyatakan bahwa bila seseorang ditemukan adanya ELC, maka orang tersebut berisiko 8,9 kali mendapat Penyakit Jantung Koroner dibanding dengan orang tanpa ELC. Simpulan: Terdapat hubungan yang sangat bermakna antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner.Kata kunci: ear lobe crease, penyakit jantung koroner.


2021 ◽  
Vol 20 (2) ◽  
Author(s):  
A. L. Burdeynaya ◽  
O. I. Afanasyeva ◽  
E. A. Klesareva ◽  
N. A. Tmoyan ◽  
O. A. Razova ◽  
...  

Aim. To study the relationship between the concentration of lipoprotein (a) (Lp (a)) and autotaxin (ATX) in patients with and without degenerative aortic valve stenosis (AoS) in the presence of coronary artery disease (CAD).Material and methods. The study included 461 patients (mean age, 66±11 years, men, 323), 354 of whom had CAD with stenosis ≥50% in at least one coronary artery according to angiography. Degenerative AoS was diagnosed with ultrasound. The control group consisted of 107 patients without CAD and degenerative AoS. Concentrations of Lp (a), ATX, lipids and blood cells were measured for all patients.Results. CAD without degenerative AoS (group 1) was diagnosed in 307 patients, while 47 patients had CAD and degenerative AoS (group 2). Patients in both groups were older than patients in the control group (66±10, 74±8, and 61±13 years, respectively). The ATX level was lower in group 1 (median [25; 75%]: 495 [406; 583] ng/ml) than in the control group (545 [412; 654] ng/ml) or group 2 (545 [476; 605] ng/ml) (p<0,05 for all). Lp (a) was lower in the control group (14,5 [5,5; 36,0] mg/dl) than in group 1 (24,9 [9,7; 58,4] mg/dl) (p<0,005) and group 2 (23,8 [9,9; 75,7] mg/dL) (p<0,05). According to the logistic regression, an increased ATX level, regardless of age and other risk factors, was associated with degenerative AoS only in patients with CAD, while age and neutrophil to lymphocyte ratio were associated with the development of degenerative AoS both in patients with CAD and the general group.Conclusion. An elevated Lp (a) level is associated with CAD regardless of the aortic valve involvement, while an increased concentration of ATX and neutrophil to lymphocyte ratio in patients with CAD were associated with degenerative AoS regardless of age and other risk factors.


Author(s):  
Dr. Sajad Hussain Bhat ◽  
Dr. Adil Majeed ◽  
Dr. Mohd Yousuf Dar ◽  
Mohd Yousuf Dar

The aim of study was to determine the sensitivity and specificity of ankle brachial index in diagnosis of peripheral arterial disease in diabetics with coronary artery disease at a teaching hospital in North India. Materials and methods: All diabetic patients admitted with coronary artery disease who undergo coronary angiography irrespective of their presentation (stable angina, unstable angina, NSTEMI, STEMI) were included in the study. Systolic blood pressures of both arms at the brachial arteries and both lower limbs at the dorsalis pedis arteries were taken with the help of sphygmomanometer and a hand held doppler probe and recorded in the proforma. The higher of the two systolic pressures recorded at the ankle was divided by the highest of the systolic pressures recorded in the arms to get the ankle brachial index. The results of ABI were compared with peripheral angiography.


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