• José M Mostaza, Luis Manzano, Carmen Suárez, Marc Cairols, Eva María Ferreira, Eduardo Rovira, Aquilino Sánchez, Manuel A Suárez-Tembra, Eva Estirado, Juan de Dios Estrella, Francisco Vega, Miguel Angel Sánchez-Zamorano, and MERITO II study.
• Unidad de Arteriosclerosis. Servicio de Medicina Interna. Hospital Carlos III. Madrid. España. jmostaza.hciii@salud.madrid.org
• Med Clin Barcelona. 2008 Nov 1; 131 (15): 561-5.

Background And ObjectivePatients with polyvascular disease have an increased rate of cardiovascular events and death. Their identification would define a subgroup of the population at very high risk, who would be candidates to intensified preventive measures. The objective of the present study was to evaluate the prevalence of subclinical peripheral artery disease in subjects with a previous diagnosis of vascular disease in other territories.Patients And MethodSubjects with a coronary or a cerebrovascular event between 3 months and 5 years, and who were attended at internal medicine outpatient clinics from Spain were included in the study. All patients had a clinical history, a physical examination, a blood and urine analysis, and a measurement of the ankle-brachial index (ABI).ResultsA total of 1203 patients (64% males; mean age: 74.3 years), were included in the study. A previous coronary event was reported in 55.4% of the participants, cerebrovascular disease in 38%, and a clinical history of disease in both territories in 6.7%. The prevalence of a low ABI (< 0,9) was 33.8%, 32.4% and 53.9% for each group, respectively. In a multivariate analysis, factors associated with a low ABI were age, smoking habit, diabetes, a reduced glomerular filtration rate, systolic blood pressure and the presence of clinical disease in both territories upon inclusion. The sensitivity of both, the Edinburgh questionnaire and pulse palpation for detecting and ABI below 0.9, were low.ConclusionsPrevalence of a low ABI is elevated in asymptomatic patients with coronary or cerebrovascular disease, particularly if there are clinical manifestations in both territories.

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