(HealthDay)—Inclusion of the ankle/brachial index (ABI) may better identify vascular disease in patients with non-valvular atrial fibrillation (NVAF), according to a study published online Aug. 14 in the Journal of the American College of Cardiology.
Francesco Violi, M.D., from the Sapienza University Of Rome, and colleagues enrolled consecutive adult patients with NVAF referred to internal medicine wards (October 2010 through October 2012) who had ABI measurements. Patients with acquired or congenital valvular AF, active cancer, disease with life expectancy less than three years, hyperthyroidism, and pregnancy were excluded.
The researchers found that, of the 2,027 NVAF patients included in the study, 83 percent had hypertension, 23 percent had diabetes mellitus, 39 percent had dyslipidemia, 29 percent had metabolic syndrome, and 15 percent smoked. Additionally, at least one atherosclerotic risk factor was detected in 90 percent of patients. Despite being at high risk for stroke, 16 percent were untreated with any antithrombotic drug, 19 percent were treated with antiplatelet drugs, 61 percent were treated with oral anticoagulants, and 4 percent were treated with both antiplatelet drugs and oral anticoagulants. Just over one-fifth (21 percent) had ABI ?0.90, indicating that NVAF is often associated with systemic atherosclerosis. Inclusion of ABI ?0.90 in the CHA2DS2-VASc score allowed for better identification of the risk profile, with an up-grading of the risk score in each score category.
"This study provides the first evidence that one-fifth of NVAF patients had an ABI ?0.90, indicating that it may represent a simple and cheap method to better define the prevalence of vascular disease in NVAF," the authors write.
One author disclosed financial ties to the pharmaceutical industry.
Explore further: GPs undertreat women with AF
Full Text (subscription or payment may be required)