Peripheral arterial occlusive disease and ankle-brachial index in patients who had coronary angiography.

OBJECTIVE: To evaluate the prevalence of peripheral arterial disease (PAD) in patients with coronary arterial disease. To evaluate the relation between ankle-brachial index (ABI) and coronary arterial disease, and its correlation with cardiovascular risk factors. METHOD: ABI investigated with Doppler ultrasonic device. Clinical characteristics researched: age, gender, diabetes, hypertension, alcoholism, smoking and obesity. POPULATION: 113 patients who had coronary angiography. First analyses: 2 groups - absence and presence of coronary arterial disease. Second analyses: 3 groups - Group 1 - absence of coronary lesion; Group 2 - stenosis <70%; and Group 3 - stenosis >70%. Third analyses: 2 groups - absence and presence of PAD. RESULTS: 90.76% of patients with coronary arterial disease presented PAD. There were significant difference including age (p<0.001), hypertension (p<0.001). smoking (p<0.001), body mass index (BMI) (p<0.001), systolic blood pressure (SBP) (p<0.001), diastolic blood pressure (DBP) (p<0.001) and pulse pressure (PP) (p<0.001) and ABI (p<0.001) between patients with and without coronary lesion. There were significant difference including age (p<0.001), diabetes (p=0.030), hypertension (p<0.001), smoking (p<0.001), BMI (p<0.001), SBP (p<0.001), DBP (p<0.001) and PP (p<0.001) and ABI (p<0.001) between patients divided as severity of coronary arterial disease. There were significant difference including age (p<0.001), hypertension (p<0.001), smoking (p<0.001), BMI (p<0.001), SBP (p<0.001), DBP (p<0.001) and PP (p<0.001) between patients with and without PAD. By Logistic Regression Analysis, old obese patients with ABI<0.90 have a risk of coronary lesion of 98.93%. CONCLUSION: ITB<0.90 might be a marker of coronary arterial disease in patients at risk of cardiovascular diseases.

Doença arterial obstrutiva periférica e índice tornozelo-braço em pacientes submetidos à angiografia coronariana / Peripheral arterial occlusive disease and ankle-brachial index in patients who had coronary angiography

OBJETIVO: Avaliar a prevalência de doença arterial obstrutiva periférica (DAOP) em coronariopatas. Avaliar a relação entre índice Tornozelo-Braço (ITB) e doença coronariana, e sua correlação com fatores de risco cardiovascular. MÉTODO: ITB investigado com ultra-sonografia Doppler. Características clínicas pesquisadas: idade, sexo, diabetes mellitus, hipertensão arterial sistêmica, etilismo, tabagismo e obesidade. População: 113 pacientes submetidos à angiografia coronariana. Primeira análise: 2 grupos - ausência e presença de coronariopatia. Segunda análise: 3 grupos - Grupo 1 - ausência de lesão coronariana; Grupo 2 - estenose < 70 por cento; e Grupo 3 - estenose > 70 por cento. Terceira análise: 2 grupos - ausência e presença de DAOP. RESULTADOS: 90,76 por cento dos coronariopatas apresentaram DAOP. Houve diferença significante quanto à faixa etária (p<0,001), hipertensão (p<0,001), tabagismo (p<0,001), IMC (p<0,001), pressão sistólica (p<0,001), diastólica (p<0,001) e de pulso (p<0,001) e ITB (p<0,001) entre indivíduos com e sem lesão coronariana. Houve diferença significante quanto à faixa etária (p<0,001), diabetes (p=0,030), hipertensão (p<0,001), tabagismo (p<0,001), IMC (p<0,001), pressão sistólica (p<0,001), diastólica (p<0,001) e de pulso (p<0,001) e ITB (p<0,001) entre os pacientes divididos quanto ao grau da coronariopatia. Houve diferença significante quanto à faixa etária (p<0,001), hipertensão (p<0,001), tabagismo (p<0,001), IMC (p<0,001), pressão sistólica (p<0,001), diastólica (p<0,001) e de pulso (p<0,001) entre pacientes com e sem DAOP. Pela Análise de Regressão Logística, pacientes idosos, obesos e com ITB < 0,90 apresentam probabilidade de lesão coronariana de 98,93 por cento. CONCLUSÃO: ITB < 0,90 constitui um possível marcador de doença arterial coronariana em pacientes com risco de doenças cardiovasculares.

OBJECTIVE: To evaluate the prevalence of peripheral arterial disease (PAD) in patients with coronary arterial disease. To evaluate the relation between ankle-brachial index (ABI) and coronary arterial disease, and its correlation with cardiovascular risk factors. METHOD: ABI investigated with Doppler ultrasonic device. Clinical characteristics researched: age, gender, diabetes, hypertension, alcoholism, smoking and obesity. Population: 113 patients who had coronary angiography. First analyses: 2 groups - absence and presence of coronary arterial disease. Second analyses: 3 groups - Group 1 - absence of coronary lesion; Group 2 - stenosis <70 percent; and Group 3 - stenosis >70 percent. Third analyses: 2 groups - absence and presence of PAD. RESULTS: 90.76 percent of patients with coronary arterial disease presented PAD. There were significant difference including age (p<0.001), hypertension (p<0.001). smoking (p<0.001), body mass index (BMI) (p<0.001), systolic blood pressure (SBP) (p<0.001), diastolic blood pressure (DBP) (p<0.001) and pulse pressure (PP) (p<0.001) and ABI (p<0.001) between patients with and without coronary lesion. There were significant difference including age (p<0.001), diabetes (p=0.030), hypertension (p<0.001), smoking (p<0.001), BMI (p<0.001), SBP (p<0.001), DBP (p<0.001) and PP (p<0.001) and ABI (p<0.001) between patients divided as severity of coronary arterial disease. There were significant difference including age (p<0.001), hypertension (p<0.001), smoking (p<0.001), BMI (p<0.001), SBP (p<0.001), DBP (p<0.001) and PP (p<0.001) between patients with and without PAD. By Logistic Regression Analysis, old obese patients with ABI<0.90 have a risk of coronary lesion of 98.93 percent. CONCLUSION: ITB<0.90 might be a marker of coronary arterial disease in patients at risk of cardiovascular diseases.

Avaliação da agregação plaquetária e dosagem do fibrinogênio em pacientes com doenças cardiovasculares e sua correlação com o uso de aspirina e fatores de risco coronariano / Evaluation of platelet aggregation and level of fibrinogen in patients with cardiovascular diseases and the correlation of taking aspirin with coronary risk factors

OBJETIVO: Avaliar a resistência à aspirina em pacientes com doenças cardiovasculares. Avaliar a dosagem do fibrinogênio sérico em pacientes usuários de aspirina, comparando-a com os que não a utilizam. Correlacionar a agregação plaquetária e o fibrinogênio sérico com parâmetros ligados ao risco cardiovascular. MÉTODO: Oitenta e dois pacientes divididos em dois grupos: grupo 1 - 41 pacientes que utilizaram aspirina na dose de 100mg/dia e grupo 2 - 41 pacientes que não utilizaram antiagregante plaquetário. Foram coletados dados epidemiológicos quanto a idade, sexo, tabagismo, etilismo, e foram realizadas dosagens de fibrinogênio sérico e agregação plaquetária. RESULTADOS: Nos grupos analisados, a idade avançada (p=0,011), o tabagismo (p=0,009) e o etilismo (p=0,007) apresentaram associação direta com o fibrinogênio sérico. Não houve correlação entre tabagismo, etilismo, fibrinogênio sérico e os valores da agregação plaquetária (p>0,05). No grupo 1, 29 por cento dos pacientes apresentaram resistência à aspirina. Destes, os tabagistas (p=0,029) e os etilistas (p=0,033) exibiram fibrinogênio sérico mais elevado. CONCLUSÃO: A resistência à aspirina esteve presente em número elevado de pacientes. Além disso, idade avançada, tabagismo e etilismo influenciaram diretamente o fibrinogênio sérico.

OBJECTIVE: To evaluate aspirin resistance in patients with cardiovascular diseases and to compare the amount of serum fibrinogen in patients taking aspirin with those who do not. To correlate the platelet aggregation and serum fibrinogen to cardiovascular risk parameters. METHODS: Eighty-two patients were divided into two groups: Group 1 - 41 patients who took 100mg aspirin daily and Group 2 - 41 patients who did not utilized platelet antiaggregates. Epidemiological data were collected including age, gender and information on smoking and alcohol intake and serum fibrinogen and platelet aggregation were mesured. RESULTS: In the groups analyzed, advanced age (p=0.011), smoking (p=0.009) and alcoholism (p=0.007) were directly associated to the serum fibrinogenen level. There were no correlations between smoking, alcoholism, serum fibrinogen and platelet aggregation values (p>0.05). In Group 1, 29 percent of the patients presented with aspirin resistance. Of these, smokers (p=0.029) and the alcoholics (p=0.033) had higher serum fibrinogen levels. CONCLUSION: Aspirin resistance was present in a high number of patients. Moreover, advanced age, smoking and alcoholism had a direct influence on the serum fibrinogen levels.