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. 2011 Jan;214(1):169-73.
doi: 10.1016/j.atherosclerosis.2010.10.011. Epub 2010 Oct 21.

Lower extremity peripheral artery disease in the absence of traditional risk factors. The Multi-Ethnic Study of Atherosclerosis

Victor Aboyans  1 , Robyn L McClelland, Matthew A Allison, Mary McGrae McDermott, Roger S Blumenthal, Katarzyna Macura, Michael H Criqui
Affiliations

Lower extremity peripheral artery disease in the absence of traditional risk factors. The Multi-Ethnic Study of Atherosclerosis

Victor Aboyans et al. Atherosclerosis. 2011 Jan.

Abstract

Objective: Lower-extremity peripheral artery disease (LE-PAD), is strongly related to traditional risk factors (smoking, hypertension, dyslipidemia, diabetes). We hypothesized that the prevalence of LE-PAD in the absence of traditional CVD risk factors is not negligible, and that this condition would remain associated with subclinical atherosclerosis in other territories.

Methods: In the Multi-Ethnic Study of Atherosclerosis, we classified participants without any traditional risk factor according to their ankle-brachial index (ABI) into 3 groups: low (<1.00), normal (1.00-1.30) and high (>1.30) ABI. Coronary or carotid artery diseases were defined by the presence of any coronary artery calcification (CAC score>0) or carotid plaque, respectively.

Results: Among the 6814 participants, 1932 had no traditional risk factors. A low- and high ABI were found in 176 (9%) and 149 (7.8%) cases, respectively. Lower glomerular filtration rate (OR: 0.88/10 units, p=0.04) and higher Interleukin-6 levels (OR: 1.42/natural-log unit, p=0.02) were associated with low ABI. Past smoking (cessation>10 years) and pulse pressure had borderline association with low ABI. In adjusted models, low-ABI was significantly associated with CAC prevalence (OR: 1.22, p<0.03). No significant association was found with carotid plaque.

Conclusion: In the absence of traditional CVD risk factors, LE-PAD is still common and associated with coronary artery disease.

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Figures

Fig. 1
Fig. 1
Probability of CAC > 0 according to the ABI values.
Fig. 2
Fig. 2
Probability of presence of carotid plaque according to the ABI values.
See this image and copyright information in PMC

Comment in

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