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Estudio multicéntrico INDAGA. Índice tobillo-brazo anormal en población mexicana con riesgo vascular
Resumen
Introducción: la enfermedad arterial periférica (EAP) está asociada con elevada morbimortalidad cardiovascular por aterosclerosis. El objetivo de esta investigación fue conocer la prevalencia de EAP y sus factores determinantes en la población mexicana.
Métodos: determinación del índice tobillo-brazo (ITB) mediante Doppler en población con alto riesgo para EAP. Se consideró un ITB ≤ 0.9 como indicador de EAP. El ITB > 1.3 se consideró indicador indirecto de calcificación y rigidez arterial.
Resultados: de 5101 pacientes, 1212 (23.8 %) tuvieron ITB ≤ 0.9 y 431 (8.4 %) ITB > 1.3 (incluyendo 1 % con arterias incompresibles). Los factores asociados con ITB ≤ 0.9 fueron la edad, la hipertensión arterial, la diabetes mellitus, el tabaquismo, la dislipidemia y el antecedente de eventos vasculares. El ITB > 1.3 se asoció con la edad, el sexo masculino, la diabetes mellitus, el tabaquismo previo y el antecedente de eventos vasculares. Una proporción elevada de pacientes con vasculopatía periférica identificada por el ITB ≤ 0.9 manifestó pocos o ningún síntoma.
Conclusiones: existe elevada prevalencia de ITB anormal en la población mexicana portadora de factores de riesgo vascular. La medición del ITB puede ayudar a identificar a los pacientes que precisan intensificación de la prevención secundaria y de tratamiento más agresivo.
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