Prevalência e fatores de risco da doença arterial periférica sintomática e assintomática em hospital terciário, Rio de Janeiro, Brasil

Abstract

Background: Peripheral arterial disease (PAD) is defined as an ankle-brachial index (ABI) < 0.90 in individuals aged 40 years or over. Prevalence is known to increase with age. Objective: To detect the prevalence of asymptomatic and symptomatic PAD, using ABI, in association with risk factors. Methods: A descriptive cohort of patients ≥ 30 years old was identified at the outpatient angiology clinic of a tertiary referral center, from December 2006 to December 2007. Previous pathologies and risk factors were analyzed in relation to PAD prevalence. ABI < 0.90 and a specific questionnaire defined symptomatic PAD with claudication, and asymptomatic PAD without claudication, both in comparison with patients without PAD (ABI 0.90-1.30). Statistical analyses were performed with SPSS, considering p < 0.05. Results: Of the 407 patients, 248 had PAD; 54% were females, with a mean age of 70.1±10.2 years (p < 0.005). PAD prevalence was 60.9% (95%CI 56-66), divided as follows: asymptomatic, 10.1% (95%CI 6.3-13.8); and symptomatic, 89.9% (95%CI 86.2-93.7). Among the symptomatic patients, 32.2% (95%CI 26.4-38.1) presented critical ischemia. Age- and sex-adjusted analyses revealed a dramatically increased prevalence in patients aged 55-74 years, with a predominance of female patients aged > 74 years (1.35:1). The prevalence of asymptomatic and symptomatic PAD was affected by smoking, hypertension, diabetes (both self-reported and confirmed), obesity, acute coronary heart disease and stroke (p < 0.005). Mean ABI was lower in symptomatic PAD (0.57±0.17) (p < 0.005). Conclusion: ABI was able to detect PAD with variable degrees of severity, associated with risk factors, by identifying symptomatic and asymptomatic PAD patients at a tertiary center. Copyright © 2009 by Sociedade Brasileira de Angiologia e de Cirurgia Vascular.