Índice tobillo-brazo en la identificación de aterogénesis subclínica en pacientes con insuficiencia hepática crónica.

Background: There is a pro-atherogenic trend in patients with chronic liver disease (CLD). The carotid intima media thickness (CIMT) by Doppler is useful for early diagnosis of subclinical atherogenesis, which correlates with cardiovascular risk factors. This study assessed the relation between subclinical atherogenesis and ankle to brachial index (ABI) in patients with CLD. Material and methods: CLD patients attending to Internal Medicine, General Hospital of Xoco from March 2014 to February 2015 were included. ABI and CIMT were measured by conventional methods. The sample was divided into two groups according to the determination of CIMT (CIMT ≤0.05cm and CIMT >0.05cm). The results were compared using mean difference, risk analysis (odds ratio), and standardization for variables of potential interaction (logistic regression). Results: Sixty patients, 53 (88.3%) males and 7 (11.6%) females, mean age 47 years-old were recruited. The ABI mean was 1.012 ± 0.144 in the group of CIMT >0.05. The ABI <0.9 was associated with CIMT risk OR = 12.42; 95% CI 1.46 - 105.7, p = 0.012. This association was modified when variables of potential interaction were added to the logistic regression, mainly uric acid (>5.2mg/dl) OR 5.3 (95% CI, 1.28-22.09), VSG (>20sec) OR 6.9 (95% CI, 1.68-28.9), age >50 years-old OR 7.1 (95% CI, 1.10-47.03). Conclusions: We found that ABI<0.9 increased by 10 times the risk of advanced subclinical atherogenesis (CIMT >0.05cm). This suggests the value of ABI as a non-invasive marker of subclinical atherogenesis and possibly also for cardiovascular events in patients with CLD. [ABSTRACT FROM AUTHOR]