ABI异常和心脑血管疾病
北京同仁医院心血管中心 (100730)
外周动脉疾病(PAD)是一种经常被忽视的疾病，在脑卒中和冠心病患者中PAD的发生率高。无论有无间歇性跛行的症状，PAD患者的心血管死亡率高。有卒中或冠心病病史的患者心血管事件的风险进一步升高。HOPE研究中踝臂指数异常对于心血管事件的发生有很大的预测价值。雷米普利可减少有或无PAD证据患者的心血管事件。但因为ABI异常的患者心血管事件的发生率显著升高，ABI异常的患者应用雷米普利的获益更大。ABI是一种可以识别高危患者以及判断哪些患者可以从治疗和预防策略中更大获益的指标。临床上须关注全身动脉粥样硬化的检查、诊断，采取可以减缓或逆转动脉粥样硬化的药物。
Abnormal ankle brachial index and cardiovascular disease
胡大一
Peripheral arterial disease (PAD) of lower arterial is a clinical condition that often been neglected. PAD is commonly encountered in patients with stroke and coronary artery disease. The population with PAD is at increased risk for cardiovascular morbidity and mortality. This increased risk is observed in both patients with claudication symptoms and those who are asymptomatic. In patients with previous stroke or myocardial infarction, the occurrence of PAD has been shown to increase the risk further. In the HOPE study, a low ankle brachial index (ABI) index was a strong predictor for cardiovascular mortality and morbidity, suggesting that low ABI has substantial prognostic value. Ramipril reduced the risk of clinical outcomes in those with a clinical evidence of PAD as well as in those without it. However, given that the event rates were higher in those with an ABI < 0.9, the absolute benefits are about twice as large in this group (50 per 1000 events prevented) compared to those with an ABI > 0.9 (24 per 1000 events prevented), This suggests that in patients with CAD and no clinical evidence of PAD, utilizing the ABI is a simple method for further identify high risk patients who can benefit from preventive strategies. ABI should be used to help define cardiovascular risk in patients with and without symptomatic cardiovascular disease and should be considered in the planning of further large cardiovascular prevention trials., 百拇医药
外周动脉疾病(PAD)是一种经常被忽视的疾病，在脑卒中和冠心病患者中PAD的发生率高。无论有无间歇性跛行的症状，PAD患者的心血管死亡率高。有卒中或冠心病病史的患者心血管事件的风险进一步升高。HOPE研究中踝臂指数异常对于心血管事件的发生有很大的预测价值。雷米普利可减少有或无PAD证据患者的心血管事件。但因为ABI异常的患者心血管事件的发生率显著升高，ABI异常的患者应用雷米普利的获益更大。ABI是一种可以识别高危患者以及判断哪些患者可以从治疗和预防策略中更大获益的指标。临床上须关注全身动脉粥样硬化的检查、诊断，采取可以减缓或逆转动脉粥样硬化的药物。
Abnormal ankle brachial index and cardiovascular disease
胡大一
Peripheral arterial disease (PAD) of lower arterial is a clinical condition that often been neglected. PAD is commonly encountered in patients with stroke and coronary artery disease. The population with PAD is at increased risk for cardiovascular morbidity and mortality. This increased risk is observed in both patients with claudication symptoms and those who are asymptomatic. In patients with previous stroke or myocardial infarction, the occurrence of PAD has been shown to increase the risk further. In the HOPE study, a low ankle brachial index (ABI) index was a strong predictor for cardiovascular mortality and morbidity, suggesting that low ABI has substantial prognostic value. Ramipril reduced the risk of clinical outcomes in those with a clinical evidence of PAD as well as in those without it. However, given that the event rates were higher in those with an ABI < 0.9, the absolute benefits are about twice as large in this group (50 per 1000 events prevented) compared to those with an ABI > 0.9 (24 per 1000 events prevented), This suggests that in patients with CAD and no clinical evidence of PAD, utilizing the ABI is a simple method for further identify high risk patients who can benefit from preventive strategies. ABI should be used to help define cardiovascular risk in patients with and without symptomatic cardiovascular disease and should be considered in the planning of further large cardiovascular prevention trials., 百拇医药