Prevalencia de enfermedad carotídea asintomática en pacientes con claudicación intermitente

Abstract

Introduction and objectives To establish both the prevalence of carotid stenosis-occlusion in patients with lower limb intermittent claudication referred to our Department between May 2007 and February 2008, and the risk factors of carotid disease. Patients and methods Cross-sectional design. Exclusion criteria: patients with previous neurological symptoms and patients with previous carotid echographic Doppler (Echo-SAT). We recorded cardiovascular risk factors, personal history of ischaemic heart disease and the presence of carotid bruit. We also performed an ankle-brachial index (ABI) and a carotid echo-Doppler. Results We analysed 173 patients, 89.6% of whom were male, with a mean age of 68.1 years and 19.7% of carotid bruit. The prevalence of >30 and >50% carotid stenosis was 15% and 9.8%, respectively, and the mean ABI was 0.68. We observed a statistically significant association between the presence of a carotid bruit and that of any degree of carotid stenosis (OR = 6; P=.0001), or the diagnosis of >50% stenosis (OR = 5.9; P=.0001). There were also significant differences in the ABI values of patients with carotid stenosis compared to patients without it (0.58 vs 0.69, P=.05). The patients with an ABI less than 0.7 had a higher prevalence of severe stenosis-occlusion than the patients with a higher ABI (10.6% vs 1.4%, P=.029). Conclusions The presence of asymptomatic carotid stenosis is not uncommon in patients with peripheral artery disease. In our study, the presence of a carotid bruit and an ABI <0.7 have shown to be markers of carotid disease.