Dépistage de l’artériopathie oblitérante des membres inférieurs par l’index de pression systolique chez les patients à haut risque cardiovasculaire. Étude observationnelle prospective sur 370 patients asymptomatiques à haut risque cardiovasculaire

Abstract

Peripheral arterial disease is a marker of systemic atherosclerosis; it is associated with a high risk of cardiovascular disease. The aim of our study was to assess the prevalence of peripheral arterial disease by measuring the ankle-brachial pressure index in patients at high cardiovascular risk and to study the risk factors associated with this disease. This was a descriptive and analytic cross-sectional study which focused on 370 patients seen at the medical consultation for atherosclerosis prevention. The ankle-brachial index was measured with a portable Doppler (BIDOP 3) using 4and 8Hz dual frequency probes. The standards were: normal ankle-brachial index 0.9to 1.3; peripheral artery obstructive disease ankle-brachial index less than 0.9; poorly compressible artery (medial arterial calcification) ankle-brachial index greater than 1.3. Cardiovascular risk factors were also studied. Three hundred and seventy subjects (mean age 65.5±8.7years) were screened Cardiovascular risk factors were: sedentary lifestyle (91.5%), hypertension (68.1%), elevated LDL-cholesterolemia (36.3%), diabetes (48.3%) and tobacco smoking (33.8%). The prevalence of peripheral artery disease was 32.4% of which 77.5% were asymptomatic. We found a significant correlation with smoking, diabetes, dyslipidemia and the presence of coronary artery disease or vascular cerebral disease. Screening for peripheral arterial disease (PAD) with the ankle-brachial index has increased the percentage of polyvascular patients from 6.2to 29%. Factors independently associated with PAD were advanced age, presence of cardiovascular disease, smoking and glycated hemoglobin. PAD is a common condition in people at high cardiovascular risk, the frequency of asymptomatic forms justifies the screening with pocket Doppler which is a simple, inexpensive and effective test to assess the overall cardiovascular risk.