getABI: German epidemiological trial on ankle brachial index for elderly patients in family practice to dedect peripheral arterial disease, significant marker for high mortality

Background: Peripheral arterial occlusive disease (PAD) is a common, but widely underestimated disease associated with a high morbidity and mortality risk. PAD can be regarded as an indicator for a generalized atherothrombosis. In view of the scarcity of appropriate representative data from Germany, we set up a large-scale epidemiological prospective observational study. Patients and methods: The primary objectives of the study comprise the estimation of the actual prevalence of PAD in unselected elderly patients, the determination of the risk factor profile of these patients, the incidence of the disease, as well as the relative risk of death due to any cause or cardiovascular, cerebrovascular or vascular events, respectively, of PAD patients compared to those without PAD, in representative primary health care settings. In addition, awareness of the problem of the disease PAD and its implications on the part of the treating physicians is determined by a Physician Awareness Questionnaire. Results: After having been trained by 34 centers of excellence (angiologists), 344 general practitioners have recruited 6880 patients aged 65 years or older and will follow them up over 3 years. Key examinations include bilateral Doppler sonographic measurements and determination of the ankle brachial index (ABI) under standardized conditions during rest and exercise, laboratory evaluations at baseline including homocysteine, physical examinations, and the WHO Rose questionnaire. The study is purely observational and no interventions are planned or stipulated. Conclusions: The getABI cohort is an important contribution to the widely neglected research area in general practice in Germany. Data from research in general practice represent the foundation for medical decision making in the sense of evidence based medicine.