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Risk factors affecting the natural history of intermittent claudication
M S Rosenbloom1, D P Flanigan, J J Schuler
1Department of Surgery, University of Illinois College of Medicine, Chicago 60612.
Archives of Surgery (Chicago, Ill. : 1960)
|July 1, 1988
Summary
Arterial disease level in claudicators doesn't predict critical ischemia. However, ankle-brachial index and its post-exercise drop are key indicators of progression in intermittent claudication patients.
Area of Science:
- Vascular Medicine
- Cardiovascular Surgery
Background:
- Intermittent claudication is a common symptom of peripheral arterial disease.
- Risk factors for disease progression require identification for effective patient management.
Purpose of the Study:
- To assess the prognostic significance of arterial disease severity in claudicators.
- To identify hemodynamic risk factors for intermittent claudication progression.
Main Methods:
- 378 intermittent claudication patients identified; serial data from 195 patients (310 limbs) analyzed.
- Life-table analysis and Cox proportional hazards regression used.
- Noninvasive vascular laboratory examinations, including ankle-brachial index (ABI) and post-exercise ABI, were performed.
Main Results:
- After 8 years, 41% progressed to critical ischemia and 50% died.
- Initial ankle-brachial index and post-exercise ABI decrease significantly predicted critical ischemia.
- Initial disease severity was not a significant predictor of progression.
Conclusions:
- Ankle-brachial index and its exercise-induced change are crucial for predicting critical ischemia in claudicators.
- Initial arterial disease level is not a reliable indicator for surgical intervention decisions.