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Open Access Highly Accessed Research article

Peripheral artery disease assessed by ankle-brachial index in patients with established cardiovascular disease or at least one risk factor for atherothrombosis - CAREFUL Study: A national, multi-center, cross-sectional observational study

Ahmet K Bozkurt1*, Ilker Tasci2, Omur Tabak3, Mehmet Gumus4 and Yesim Kaplan5

Author Affiliations

1 Department of Cardiovascular Surgery, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey

2 Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey

3 Internal Medicine Clinic, Ministry of Health Istanbul Training and Research Hospital, Istanbul, Turkey

4 Avcılar Anadolu Hospital, Istanbul, Turkey

5 sanofi aventis, Istanbul, Turkey

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BMC Cardiovascular Disorders 2011, 11:4  doi:10.1186/1471-2261-11-4

Published: 19 January 2011

Abstract

Background

To investigate the presence of peripheral artery disease (PAD) via the ankle brachial index (ABI) in patients with known cardiovascular and/or cerebrovascular diseases or with at least one risk factor for atherothrombosis.

Methods

Patients with a history of atherothrombotic events, or aged 50-69 years with at least one cardiovascular risk factor, or > = 70 years of age were included in this multicenter, cross-sectional, non-interventional study (DIREGL04074). Demographics, medical history, physical examination findings, and physician awareness of PAD were analyzed. The number of patients with low ABI (< = 0.90) was analyzed.

Results

A total of 530 patients (mean age, 63.4 ± 8.7 years; 50.2% female) were enrolled. Hypertension and dyslipidemia were present in 88.7% and 65.5% of patients, respectively. PAD-related symptoms were evident in about one-third of the patients, and at least one of the pedal pulses was negative in 6.5% of patients. The frequency of low ABI was 20.0% in the whole study population and 30% for patients older than 70 years. Older age, greater number of total risk factors, and presence of PAD-related physical findings were associated with increased likelihood of low ABI (p < 0.001). There was no gender difference in the prevalence of low ABI, PAD symptoms, or total number of risk factors. Exercise (33.6%) was the most common non-pharmacological option recommended by physicians, and acetylsalicylic acid (ASA) (45.4%) was the most frequently prescribed medication for PAD.

Conclusion

Our results indicate that advanced age, greater number of total risk factors and presence of PAD-related physical findings were associated with increased likelihood of low ABI. These findings are similar to those reported in similar studies of different populations, and document a fairly high prevalence of PAD in a Mediterranean country.