Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3459172 | Atención Primaria | 2006 | 6 Pages |
ObjetivoEstudiar la relación entre lapresencia de arteriopatía periférica (AP) y morbimortalidad a los 6 años, y el valor delíndice tobillo-brazo (ITB) como predictorde morbimortalidad en la diabetes mellitus tipo 2.DiseñoEstudio de cohorte retrospectivo.Seguimiento de 6 años.EmplazamientoCentro de salud urbano.ParticipantesEn total, 269 diabéticos no insulinodependientes, de los cuales 63 tenían AP en 1996: 20 estaban previamente diagnosticados y 43 presentaban un ITB ≤ 0,90.Mediciones principalesSe citó a los pacientespara conocer la incidencia de eventosmicrovasculares y macrovasculares mortales yno mortales y se revisaron las historias. Seexcluyó a 6 por no disponer de todos los datos.ResultadosHan fallecido 39 pacientes, 19 de los cuales presentaban AP en 1996(30,1%) y 20 no (9,7%) (p = 0,001).Fallecieron 16 pacientes en el grupo con ITB ≤ 0,9 (30,2%) y 21 (10,1%) en el grupocon valores de ITB normales (p = 0,001).Murieron por causa cardiovascular 7 pacientes (13,2%) con ITB patológico y 8(3,9%) con exploración normal (p = 0,009).La presencia de AP se ha asociado con unamayor probabilidad de presentar un episodiono mortal de cardiopatía isquémica (p = 0,04), un accidente cerebrovascular (ACV) (p < 0,001) y úlceras (p = 0,006). Un ITB bajo se ha asociado con una mayorprobabilidad de presentar un eventocardiovascular, mortal o no (p < 0,001).Tras el análisis multivariable se observa unaumento de morbimortalidad cardiovascular(odds ratio [OR] = 2,81; intervalo deconfianza [IC] del 95%, 1,16-6,78), ACV(OR = 3,47; IC del 95%, 1,19-10,07) einsuficiencia cardíaca (OR = 6,75; IC del95%, 1,34-33,81) en los diabéticos con ITB = 0,90.ConclusionesLos diabéticos tipo 2 con AP presentan una mayor morbimortalidad. ElITB es un buen predictor de morbimortalidad cardiovascular e insuficiencia cardíaca.
ObjectiveTo study the relationship between the presence of peripheral artery disease(PAD) and the morbidity and mortality at 6years, and the ankle-brachial index (ABI) as a predictor of morbidity and mortality in type 2 diabetes mellitus.DesignRetrospective cohort study. Six years follow-up.SettingUrban health centre.ParticipantsA total of 269 type 2 diabetics,of which 63 had PAD in 1996: 20 were previously diagnosed and 43 had an ABI of ≤ 0.90.Principal measurementsAn appointed was made with the patients to find out the incidence of fatal and non-fatal microvascular and macrovascular events and the histories were reviewed. Six patients were excluded as all their data were not available.ResultsThirty nine patients had died, of whom 19 had PAD in 1996 (30.1%) and 20 did not (9.7%) (P = .001).Sixteen patients died in the group with an ABI ≤ 0.9 (30.2%) and 21 (10.1%) in the group with normal ABI values (P = .001).7 (13.2%) patients died due to a cardiovascular cause with a pathological ABI, and 8 (3.9%) with a normal value (P =.009).The presence of PAD has been associated witha higher probability of having a non-fatal episode of ischaemic cardiac disease (P =.04), a cerebrovascular accident (CVA) (P<.001) and ulcers (P =.006). A low ABI has been associated with a higher probability of presenting with a fatal or non-fatal cardiovascular event (P <.001).After the multivariate analysis an increase was observed in cardiovascular (odds ratio [OR]=2.81; 95% confidence interval [CI], 1.16-6.78), CVA (OR=3.47; 95% CI, 1.19-10.07),and cardiac failure (OR=6.75; 95% CI, 1.34-33.81), morbidity and mortality in diabetics with an ABI of ≤0.90.ConclusionsThe type 2 diabetics with PAD present with a higher morbidity and mortality.The ABI is a good predictor of cardiovascular disease and heart failure morbidity and mortality.