Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492009005000009
Jornal Vascular Brasileiro
Original Article

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

Marilia Duarte Brandão Panico; Ethel Stambovsky Spichler; Mario Fritsch Neves; Liana Wernersbach Pinto; David Spichler

Downloads: 0
Views: 1055

Resumo

CONTEXTO: Doença arterial periférica é caracterizada pelo índice tornozelo-braquial (ITB) < 0,90, em indivíduos ≥ 40 anos, aumentando a prevalência com a idade. OBJETIVO: Detectar a prevalência de doença arterial periférica assintomática e sintomática, com introdução do ITB, associada a fatores de risco demarcados. MÉTODOS: Coorte descritiva identificada em unidade hospitalar terciária de angiologia, de dezembro de 2006 a dezembro de 2007, com idade ≥ 30 anos. Doenças pregressas e fatores de risco foram analisados associados à prevalência. ITB < 0,90 e questionário padronizado definiram doença arterial periférica sintomática com claudicação e assintomática com ausência de claudicação, ambas comparadas aos sem doença arterial periférica (ITB 0,90-1,30). A análise estatística utilizou programa SPSS, com significância de p < 0,05. RESULTADOS: Dos 407 pacientes, 248 apresentaram doença arterial periférica, sendo 52,2% do sexo feminino, com média de idade de 70,1±10,2 anos (p < 0,005). A prevalência de 60,9% (IC95% 56-66) foi subdividida em: assintomática, 10,1% (IC95% 6,3-13,8); e sintomática, 89,9% (IC95% 86,2-93,7). Destes, 32,2% (IC95% 26,4-38,1) apresentaram isquemia crítica. Ajustada por sexo e idade, a prevalência aumenta significativamente entre 55-74 anos, com predomínio do feminino (1,35:1) nos indivíduos acima de 74 anos. A prevalência dos assintomáticos e sintomáticos foi influenciada por tabagismo, hipertensão, diabéticos autorreferidos e confirmados, sobrepeso, infarto agudo do miocárdio e acidente vascular encefálico (p < 0,005). A média do ITB foi mais baixa nos sintomáticos (0,57±0,17) (p < 0,005). CONCLUSÃO: O ITB detectou doença arterial periférica com graus variáveis de gravidade associada a fatores de risco, identificando os assintomáticos não-claudicantes e os sintomáticos em unidade terciária.

Palavras-chave

Doença arterial periférica sintomática e assintomática, diagnóstico, índice tornozelo-braquial, prevalência, fatores de risco

References

McDermott MM, Criqui MH, Liu K. Lower ankle/brachial index, as calculated by averaging the dorsalis pedis and posterior tibial arterial pressures, and association with leg functioning in peripheral arterial disease. J Vasc Surg.. 2000;32:1164-71.

Fowkes F, Lee A, Murray G. On behalf of the ABI collaboration. Ankle-Brachial Index as an independent indicator of mortality of fifteen international population cohort studies. Circulation.. 2005;112:3704.

Peripheral arterial disease in people with diabetes. Diabetes Care.. 2003;26:3333-41.

Hirsch AT, Haskal ZJ, Hertzer NR. ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation.. 2006;113:463-654.

Weitz JI, Byrne J, Clagget GP. Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review. Circulation.. 1996;94:3026-49.

Management of the peripheral arterial disease (PAD). Eur J Endovasc Surg. 2000;19(^sA):S1-S250.

TransAtlantic Inter-Society Consensus (TASC). Management of the peripheral arterial disease (PAD). Int Angiol. 2000;19(1^s1):1-XXIV.

Dormandy JA, Rutherford RB. Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter-Society Consensus (TASC). J Vasc Surg.. 2000;31:S1-S296.

Norgren L, Hiatt WR, Dormandy JA. Inter-Society Consensus for the management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45(^s1):S5-S67.

Spichler ER, Spichler D, Lessa I, Costa e Forti A, Franco LJ, LaPorte RE. Capture-recapture method to estimate lower extremity amputation rates in Rio de Janeiro, Brazil. Rev Panam Salud Publica.. 2001;10:334-40.

Spichler D, Miranda Jr. F, Spichler ES, Franco LJ. Major lower extremity amputations related to peripheral arterial disease and diabetes mellitus in the city of Rio de Janeiro. J Vasc Bras.. 2004;3:111-22.

Lijmer JG, Hunink MG, van den Dungen JJ, Loonstra J, Smit AJ. ROC analysis of noninvasive tests for peripheral arterial disease. Ultrasound Med Biol.. 1996;22:391-8.

Criqui MH, Denenberg JO, Langer RD, Fronek A. The epidemiology of peripheral arterial disease: importance of identifying the population at risk. Vasc Med.. 1997;2:221-6.

Mohler III ER. Peripheral Arterial. Disease Curr Treat Options Cardiovasc Med. 1999;1:27-34.

Diagnosis and classification of diabetes mellitus. Diabetes Care. 2008;31:S55-60.

Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2009;32:S62-7.

Williams B, Poulter NR, Brown MJ. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens.. 2004;18:139-85.

Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med. 1998;158:1855-67.

Alberti KG, Zimmet P, Shaw J. Metabolic syndrome- a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med.. 2006;23:469-80.

Criqui MH, Denenberg JO, Bird CE, Fronek A, Klauber MR, Langer RD. The correlation between symptoms and non-invasive test results in patients referred for peripheral arterial disease testing. Vasc Med.. 1996;1:65-71.

Hirsch AT, Criqui MH, Treat-Jacobson D. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA.. 2001;286:1317-24.

McDermott MM, Fried L, Simonsick E, Ling S, Guralnik JM. Asymptomatic peripheral arterial disease is independently associated with impaired lower extremity functioning: the women's health and aging study. Circulation. 2000;101:1007-12. Erratum in: Circulation.. 2001;104:504.

Lange SF, Trampisch HJ, Pittrow D. Profound influence of different methods for determination of the ankle brachial index on the prevalence estimate of peripheral arterial disease. BMC Public Health.. 2007;7:147.

Nunes JL, Silvany-Neto A, Pitta GB. Prevalence of peripheral arterial occlusive disease in patients referred to a tertiary care hospital in Salvador, Bahia, Brazil, for coronary angiography. Braz J Med Biol Res.. 2008;41:202-8.

Bhatt DL, Steg PG, Ohman EM. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA.. 2006;295:180-9.

McDermott MM, Guralnik JM, Ferrucci L. Asymptomatic peripheral arterial disease is associated with more adverse lower extremity characteristics than intermittent claudication. Circulation.. 2008;117:2484-91.

Dolan NC, Liu K, Criqui MH. Peripheral artery disease, diabetes, and reduced lower extremity functioning. Diabetes Care.. 2002;25:113-120.

Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation.. 2004;110:738-43.

Regensteiner JG, Hiatt WR, Coll JR. The impact of peripheral arterial disease on health-related quality of life in the Peripheral Arterial Disease Awareness, Risk, and Treatment: New Resources for Survival (PARTNERS) Program. Vasc Med.. 2008;13:15-24.

Dormandy J, Heeck L, Vig S. P redicting which patients will develop chronic criti c al leg ischemia. Semin Vasc S urg.. 1999;12:138-41.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddfc4160e882573734ce1d5 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections