medigraphic.com
Órgano de Difusión de la Asociación Académica Panamericana de Medicina Familiar A.C.

2017, Number 3

<< Back Next >>

Arch Med Fam 2017; 19 (3)

Importance of Measuring the Ankle-Brachial Index in Cardiovascular Risk Assessment in Adults Younger than 40 Years of Age

Rubio GAF, Morales LH, Huerta RS, Garro AAK, Cortés RPS, Vargas AG, Duran SMB

Language: Spanish
References: 6
Page: 63-67
PDF size: 43.09 Kb.


ABSTRACT

Objective: To determine if the measurement of Ankle Brachial Index (ABI) modifies the cardiovascular risk in young adults. Methods: We evaluated 103 patients ‹40 years of age, normotensive nondiabetics with no history of cardiovascular disease, who attended preanesthetic evaluation by noncardiac surgery. In all of them, the different atherogenic risk factors were sought. The ABI was recorded in all subjects using Doppler of 5 mega Hertz, an ABI between 0.9 and 1.3 was considered normal. Statistical analysis was performed with odds ratio and linear regression. Results: Of the 103 patients, 36 (34.9%) had abnormal ABI, the linear regression did not find that any risk factor correlated in isolation with abnormal ABI. Notably, the performance of the IBT allowed the reclassification of 14 patients (13.6%) at a high cardiovascular risk. 72 patients met diagnostic criteria for metabolic syndrome, the odds ratio for abnormal IBT in subjects with metabolic syndrome was 3.67 (95% CI: 1.4-9.5, p = 0.0078). Conclusions: We found a high prevalence of decreased IBT in young subjects, which is not related to any risk factor in isolation, but with the coexistence of several of them. It is noteworthy that a significant percentage of the subjects see their cardiovascular risk reclassified by adding the results of the IBT, so the measurement of this index should be included in the programs for the detection of cardiovascular risk, and perhaps also in the preoperative assessment. By the age of patients, highlights the importance of implementing preventive and lifestyle modifications since childhood measures.


REFERENCES

  1. Guía de práctica clínica IMSS-455-11 para la valoración perioperatoria en cirugía no cardíaca en adultos. Secretaría de Salud, 2010.

  2. González-Chon O, Acosta-Garduño F, Marrón PM, Mille LJE, Cisneros RFJ. ¿Qué hay de nuevo en las Guías de Valoración Preoperatoria? Rev Mex Anest 2015; 38 (S1): 35-39.

  3. Kristensen SD, Knuuti J, Saraste A. A nombre del Grupo de Trabajo Conjunto sobre cirugía no cardiaca: Evaluación y manejo cardiovascular de la Sociedad Europea de Cardiología (ESC) y la European Society of Anesthesiology (ESA). En: Guía de práctica clínica de la ESC/ESA 2014 sobre cirugía no cardiaca: evaluación y manejo cardiovascular. Rev Esp Cardiol. 2014;67:1052.e1-e43

  4. Cantú-Brito C, Chiquete E, Duarte-Vega M, Rubio-Guerra A, Herrera-Cornejo M, Nettel-García J. Anklebrachial index assessed in a Mexican population with vascular risk. The INDAGA study. Rev Med Inst Mex Seguro Soc. 2011;49:239-46.

  5. The Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). ESC Committee for Practice Guidelines. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2011;32:2851-906.

  6. Rubio-Guerra AF. Clinical forum: Hipertensión arterial en el paciente con enfermedad arterial periférica. Rev Invest Clin 2013;65:263-268.




2020     |     www.medigraphic.com