Screening of unrecognized peripheral arterial disease (PAD) using ankle-brachial index in high cardiovascular risk patients free from symptomatic PAD

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Presentation transcript:

Screening of unrecognized peripheral arterial disease (PAD) using ankle-brachial index in high cardiovascular risk patients free from symptomatic PAD Jean-Jacques Mourad, MD, PhD, Patrice Cacoub, MD, PhD, Jean-Philippe Collet, MD, PhD, François Becker, MD, PhD, Jean-François Pinel, MD, Dominique Huet, MD, Marie-Antoinette Sevestre-Pietri, MD, Pascal Priollet, MD Journal of Vascular Surgery Volume 50, Issue 3, Pages 572-580 (September 2009) DOI: 10.1016/j.jvs.2009.04.055 Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 1 Distribution of patients before and after ankle-brachial index calculation for peripheral arterial disease. A, At inclusion, high risk, asymptomatic patients were divided into four groups: patients with (1) documented coronary disease, (2) documented cerebrovascular disease, (3) documented polyvascular disease (both coronary and cerebrovascular disease), and (4) at least one cardiovascular risk factor but no coronary or cerebrovascular disease. B, After ankle-brachial index calculation. *Coronary patients with PAD and cerebrovascular patients with PAD were counted as polyvascular patients. PAD, Peripheral arterial disease. Journal of Vascular Surgery 2009 50, 572-580DOI: (10.1016/j.jvs.2009.04.055) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 2 Multivariate analysis. Risk of peripheral arterial disease significantly increased with absence of ≥1 pulse, arterial bruit, previous non-Q-wave MI, smoking, age ≥81 years, creatinine clearance <60 mL/min, and treated hypertension. Odds ratios and 95% CI are presented. CI, Confidence intervals; creat Cl, creatinine clearance; MI, myocardial infarction; OR, odds ratio; TIA, transient ischemic attack. Journal of Vascular Surgery 2009 50, 572-580DOI: (10.1016/j.jvs.2009.04.055) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 3 Receiver operating characteristic curve. Risk increased with the number of risk factors for peripheral arterial disease. Area under the curve was 0.66. Model was not considered discriminatory. AUC, Area under the curve; FPR, false positive rate; TPR, true positive rate. Journal of Vascular Surgery 2009 50, 572-580DOI: (10.1016/j.jvs.2009.04.055) Copyright © 2009 Society for Vascular Surgery Terms and Conditions