Índice tornozelo-braquial na avaliação de risco cardiovascular em pacientes diabéticos

Abstract

Introduction Ankle-brachial index (ABI) is a simple tool for the early detection of cardiovascular diseases (CVD), which accounts for the majority of deaths in diabetics. This study aimed to verify the frequency of ABI change and its association with demographic and clinical data in diabetic patients attended at a Center specialized in the state of Sergipe. Materials and methods: A cross-sectional study with 293 worksheets for examination of diabetic foot. It was evaluated: age, gender, time of DM, glycemic control, comorbidities, DM complications and ABI. Patients were divided into four groups: definitive PAOD (ABI ≤ 0.90), Borderline (ABI between 0.91-0.99), normal arteries (ABI between 1.00-1.29) and arterial calcification (ABI ≥ 1.3). The categorical variables were expressed in absolute and relative frequencies with inferential analysis using the Pearson chi-square or Fischer's Exact Test, and the numerical variables were analyzed through central tendency and variability measures, evaluated by the Mann-Whitney test and of Kruskal Wallis, with a significance level of 0.05. Results and discussion The majority of patients had altered ABI related to CVD. PAOD was related to age, time of DM, neuropathy, retinopathy, foot injury and amputation. Borderline patients were younger, which may indicate an early stage of PAOD. Arterial calcification was more prevalent in men and related to neuropathy, which can be seen both as a cause and as a consequence of arterial stiffening. Conclusion The simple adoption of the ABI measure in the follow-up of diabetic patients may lead to the early diagnosis of asymptomatic CVD patients, making possible the adoption of preventive measures that could contribute to the reduction of morbidity and mortality.