El Grosor íntima-media de la arteria femoral superficial como marcador de la aterosclerosis y de la enfermedad arterial periférica

1-Introduction: Intima-media thickness of the carotid artery, measured with doppler ultrasound is considered an early marker for cardiovascular diseases121. Peripheral arterial disease (PAD) is a highly prevalent and costly health condition1-3. The ankle-brachial index (ABI) is currently defined as the "gold-standard" for the diagnosis of PAD, as it is closely related with cardiovascular events and their prognosis132. Doppler ultrasound exploration of the superficial femoral artery is fast, painless, cost-effective and reproducible and provides additional information to ABI. 2-Hypothesis: Pre-Hunter intima-media thickness of the superficial femoral artery (SFA IMT) may be a marker for peripheral arterial disease. 3-Objetive: Assess the usefulness of pre-Hunter SFA IMT in the diagnosis and/or prognosis of PAD, comparing the relation of IMT with: - ABI. - Fontaine stages of intermittent claudication (IC). - Number of cardiovascular risk factors (CRF). 4-Material and Methods The study was assessed and approved by the Ethics Committee and written informed consent of all patients was obtained. Design: a transversal study performed in 2011, with follow-up in 2015. 167 patients were included between January-September 2011. Inclusion criteria: age ≥ 50 years, ≥1 CRF (diabetes mellitus, hypertension, dyslipaemia, smoking). Exclusion criteria: PAD Fontaine stage III or IV. Collected data: - First visit 2011: blood test (leukocytes, monocytes, total cholesterol, LDL-C , HDL-C, triglycerides, glycaemia, glycosylated haemoglobin), ABI, SFA IMT by doppler ultrasound in millimetres, CRF and cardiovascular events, body mass index and waist circumference. - Second visit 2015: SFA IMT by doppler ultrasound in millimetres, ABI, new cardiovascular events, body mass index and waist circumference. Statistical Analysis: - Descriptive: quantitative variables (median; standard deviation); qualitative variables (absolute and relative frequencies). - Analytical: multilevel models. Data analysis: R Core Team (2015) statistical package. Graphs: quantitative variables (Scatter plots); qualitative variables (Box plots) Statistical level: 0.05. 5-Results: - 2011 visit: 167 patients, 52% women and 48% men, mean age 69 years. - 2015 control visit: 145 patients, 3 died and 19 were lost to follow-up. - Descriptive analysis: 31.7% of patients had IC of the right leg and 28% of the left; 35% had 2 CRF; arterial hypertension was the most common CRF (73%); 10% had a history of acute myocardial i