全科医生中冠状动脉疾病稳定期患者的外周动脉疾病:意大利全国性研究--PAD & CAD 研究的结果。

IF 3.2 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Internal and Emergency Medicine Pub Date : 2025-01-01 Epub Date: 2024-09-30 DOI:10.1007/s11739-024-03771-9
Marta Baviera, Andreana Foresta, Luisa Ojeda Fernandez, Ginevra Torrigiani, Mauro Tettamanti, Maria Carla Roncaglioni, Claudio Cimminiello
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引用次数: 0

摘要

冠状动脉疾病(CAD)患者中外周动脉疾病(PAD)的诊断率仍然偏低,在常规临床实践中测量筛查 PAD 的障碍依然存在。我们使用一种简便的自动踝肱压指数(ABI)测量仪器,评估了意大利初级医疗机构中 CAD 患者的 PAD 患病率。我们对 32 名全科医生(GP)进行了一项多中心观察研究。将 ABI 值异常或有 PAD 相关症状或下肢血管再通手术史的患者人数除以纳入研究的患者总人数,计算出 PAD 的患病率。此外,还评估了 CAD 组和 CAD + PAD 组患者在 12 个月内主要心血管临床事件和全因死亡的发生率。研究共纳入了 713 名 CAD 患者,其中 148 名(20.8%)患者同时患有 PAD,其中近 15%(106 人)无症状。35.4%的患者 ABI 值小于 0.9,46.0%的患者 ABI 值大于 1.3。PAD患者的主要心血管事件和全因死亡发生率明显高于非PAD患者。超过 80% 的患者接受了二级 CV 预防治疗,组间存在差异。我们的研究结果表明,使用一种简便的自动仪器测量 ABI,护士很容易就能操作,这样就能在一定比例的 CAD 患者中发现 PAD,否则这些患者就不会被发现。这鼓励在初级医疗机构中开展 PAD 筛查,以优化与 PAD 相关的主要冠状动脉风险因素的管理。NCT编号:NCT03921905:NCT03921905。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Peripheral artery disease in patients with stable coronary artery disease in general practice: results from an Italian nationwide study-PAD & CAD study.

Peripheral artery disease (PAD) remains underdiagnosed in patients with coronary artery disease (CAD) and barriers persist to measure screening PAD in routine clinical practice. We assessed the prevalence of PAD in patients with CAD in Italian primary care setting using an easy automatic instrument to measure ankle brachial pressure index (ABI). A multicenter, observational study was conducted with 32 General Practitioners (GPs). Prevalence of PAD was calculated dividing the number of patients with abnormal ABI value, or with symptoms associated with PAD or history of lower limb revascularization procedures, over the total number of patients included in the study. Incidence of major CV clinical events and all-cause death was also evaluated at 12 months in both CAD and CAD + PAD groups. In total, 713 CAD patients were included in the study, 148 (20.8%) patients had also PAD, asymptomatic in nearly 15% of them (106). The 35.4% of patients had ABI value ≤ 0.9 and 46.0% > 1.3 ABI. A significantly higher incidence of major CV events and all-cause death was seen in patients with PAD than in those without. Over 80% of patients received the therapy for secondary CV prevention and difference was seen between groups. Our findings showed that the use of an easy automatic instrument to measure ABI, easily managed by nurses, allowed to detect PAD in a relevant proportion of CAD patients who otherwise would not have been recognized. This encourages performing PAD screening in primary care setting to optimize the management of major CV risk factors associated with PAD. NCTumber: NCT03921905.

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来源期刊
Internal and Emergency Medicine
Internal and Emergency Medicine 医学-医学:内科
CiteScore
7.20
自引率
4.30%
发文量
258
审稿时长
6-12 weeks
期刊介绍: Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.
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