ankle-brachial index recognizes the high cardiovascular risk in patients with coronary disease or stroke, but not be extrapolated to diabetic subjects, because they in themselves are already sufficient cardiovascular risk. It is the conclusion of a study published in the journal Atherosclerosis, which has awarded the grants Serrano Rios Diabetes Group of the English Society of Internal Medicine, which recognizes the best article published. The first author is José Mustard, Internal Medicine Service, Hospital Carlos III, Madrid. Mustard
explained that the study was conducted over a thousand patients with coronary or cerebrovascular disease, in which we measured the ankle-brachial index. "They were followed for one year to see the relationship between the emergence of new heart attacks, stroke or cardiovascular mortality depending on the measurement of that parameter. "After following up," showed that patients with a low ankle-brachial index, which have already developed a peripheral arterial disease have higher mortality and higher complication rate cardivosculares if compared to those with a normal rate.
Previous data
Mustard remember that these results had been found in subjects without previous illness. "What we showed is now useful in patients who already have illness. "The work we have observed that this parameter is valid for non-diabetic patients but not for diabetics. "For a diabetic who already have heart disease or stroke rate of cardiovascular risk is much higher than non-diabetics, but no matter the ankle-brachial index, because diabetics are already bad in itself your arteries. The situation is so bad that the cardiovascular risk is independent of ankle-brachial index.
This suggests Mustard, taking into account the study is that the ankle-brachial index is appropriate in patients with cardiovascular disease. "In this group worthwhile measure, because it identifies the increased risk of cardiovascular disease." But in diabetics, as the risk of complications is very high, the situation changes, since poor cardiovascular status is independent of ankle-brachial index. Recommendations
This factor is already introduced and accepted by various companies to determine in patients without cardiovascular disease, and another for identifying the risk and aggressive preventive measures. Mustard says he recommends lowering LDL to below 100 in patients at high risk and below 70 in the high risk patients such as diabetics, those who continue to smoke or those who have controlled their disease. "In this group of patients must be very aggressive in managing their cardiovascular risk factors."
Via: diariomedico.com
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