Fecha de la publicación: 24/09/2018
Autor: Paloma Laguna 1, Nicolás Roberto Robles 2 3, Juan Lopez Gomez 4, Sergio Barroso 5, Gabriel Collado 1
1Servicio de Cirugía Vascular, Unidad de Hipertensión Arterial, Hospital Infanta Cristina, Carretera de Portugal s/n., 06070, Badajoz, Spain.
2Unidad de Hipertensión Arterial, Hospital Infanta Cristina, Carretera de Portugal s/n., 06070, Badajoz, Spain. email@example.com.
3Cátedra de Riesgo Cardiovascular, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain. firstname.lastname@example.org.
4Servicio de Bioquímica Clínica, Hospital Infanta Cristina, Badajoz, Spain.
5Unidad de Hipertensión Arterial, Hospital Infanta Cristina, Carretera de Portugal s/n., 06070, Badajoz, Spain.
Introduction: Increased carotid intima-media thickness (IMT) measurement is usually seen as a surrogate marker of peripheral artery disease (PAD) but there is scarce cumulated evidence to support this view.
Aim: To evaluate prevalence of increased IMT among patients with symptomatic PAD as well as the frequency of some cardiovascular risk factors in these patients.
Methods: They were recruited 230 patients with diagnosis of medium peripheral artery disease in the Vascular Surgery Service outpatient’s office. Serum cystatin C, homocysteine, and lipoprotein (a) were measured. GFR was estimated using the CKD-EPI equation and the Larsson one from cystatin C.
Results: The global prevalence of increased IMT was 16.5% (n = 38, 95% CI 12.3-21.9). In all the frequency of hyperlipoproteinemia (a) was 34.2% (95% CI 28.4-40.5%). The global prevalence of hyperhomocysteinemia was 61.5% (95% CI 54.6-68.1%) and the proportion of patients with high cystatin C levels was 38.5% (95% CI 32.1-42.5). The prevalence of stage III chronic kidney disease or higher by CKD-EPI formula was much lesser (13.6%, 95% CI 9.7-18.7) as was the frequency obtained by the Larsson equation (28.7%, 95% CI 23.2-34.9). No differences were found between groups.
Conclusions: Increased IMT is not common among PAD patients. Hyperlipoproteinemia (a) and hyperhomocysteinemia are very frequent in these patients. High serum cystatin levels are also very prevalent but reduced GFR is not so frequent. There were no differences in the prevalence of the studied cardiovascular risk factors between those patients with increased IMT and those ones with normal IMT.