PURPOSE: Peripheral artery disease (PAD) is a major cause of acute and chronic illness. The prevalence of PAD has not been fully validated using both ABI and Edinburgh Claudication Questionnaire in HIV-infected patients. We propose to conduct a study to analyze the prevalence of PAD and its risk factors in HIV-infected patients using non-HIV patients as a study control.
METHODS: Single center study performed at St. Joseph’s Regional Medical Center (SJRMC). Control group included patients without HIV from outpatient and inpatient services. ABI was measured at rest and post-exercise. Exercise was defined as 20 squats performed slowly under supervision; rest was defined as a patient lying supine for 5 minutes. Symptoms potentially related to PAD (claudication, rest pain) were recorded using the Edinburgh Claudication Questionnaire. Previous history of PAD.
RESULTS: : A total of 214 patients were enrolled in the study, 144 controls and 70 patients with HIV. Among control patients, the average age was, 53.5% were male, 30.6% were Caucasian, 66.7% had hypertension, 43.1% had diabetes, 30.6% abused tobacco, and 4.2% had metabolic syndrome. Among the patients with HIV,53.6% were male, 13.0% were Caucasian, 39.1% had hypertension, 20.3% had diabetes, 37.7% abused tobacco. Patients with HIV tended to have a higher prevalence of severe claudication than controls (28.6% vs. 12.5%, p=0.0069). Patients with HIV and an ABI < 0.9 also had more severe claudication, though not significantly.
CONCLUSIONS: : Now, the result of our study implies that Edinburg score in conjuncture with ABI yields better results in assessment of diagnosing PAD in HIV patients. This is of great significance, and henceforth, the diagnostic strategies of HIV-infected patients should not only focus on the ABI but also on the Edinburg score.
CLINICAL IMPLICATIONS: New PAD diagnosis standard.
DISCLOSURE: The following authors have nothing to disclose: Jayanth Koneru, Nishant Gupta, Mahesh Bikkina, Vincent Debari, Fayez Shamoon
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