Ankle-brachial index as a predictor of coronary disease events in elderly patients submitted to coronary angiography

BackgroundThe ankle-brachial index (ABI) is a simple, non-invasive, and inexpensive method used in the diagnosis of peripheral arterial disease (PAD) and can identify individuals at risk for cardiovascular disease in other arteries of the body, especially the coronary and carotid arteries. The primary objective of this study was to assess whether patients with an ABI < 0.9 have more severe coronary artery disease detected on coronary angiography compared to patients with a normal ABI.MethodsThis is a prospective, analytical, cross-sectional study that was performed from July 1, 2013 to June 31, 2014 that recruited 163 patients (101 men (62%) and 62 women (38%)) according to the inclusion and exclusion criteria. All patients underwent coronary angiography, and then ABI measurements were performed. Pearson’s Chi-square and Student’s t-tests were used to compare variables between groups. The Poisson regression model was used to evaluate whether ABI was an independent predictor of stenoses > 50%.ResultsThe prevalence of ABI < 0.9 was 9.8%. Patients with an ABI < 0.9 had a higher prevalence of stenoses ≥ 50% in the left anterior descendant (LAD) (68.7% vs. 36%, P = 0.02) and left main (8.7% vs. 0.6%, P < 0.001) than those with a normal ABI. On multivariate Poisson regression, an ABI < 0.9 was an independent predictor of stenosis ≥ 50% in the LAD (odds ratio (OR): 2.05 (1.39 - 3.04), P < 0.001).ConclusionsPatients with an ABI < 0.9 had a higher prevalence of stenoses ≥ 50% in the LAD and left main than those with a normal ABI. An abnormal ABI was an independent predictor of lesions ≥ 50% in LAD.

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“…Studies have shown that patients with an ABI < 0.9 had a higher prevalence of multi-vessel CAD than those with a normal index [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Association Between Ankle-Brachial Index and Coronary Lesions Assessed by Coronary Angiography

Oliveira¹,

Correia²,

Neto³

et al. 2015

Cardiol Res

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“…In the present study, most of the patients belonged to age group of 51 -60 years. It is known that ageing leads to decreased ankle-brachial index as a result of arterial stiffening [13]. Further, a significant male predominance is commonly observed in majority of studies on coronary artery disease and peripheral arterial disease.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Ankle-Brachial Index, Waist-Hip Ratio, Ejection-Fraction, Obesity, Smoking, Alcohol Habits, Diabetes and Hypertension as Independent Predictors of Complexity and Severity of Coronary Artery Disease

Cheruku¹,

Otikunta²,

Reddy³

et al. 2015

IJCM

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Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and complexity of coronary artery disease. Methods: Patients diagnosed with coronary artery disease at our hospital between September-2012 and December-2014 were examined in this study. Selected patients were screened for cardiovascular risk factors including diabetes, hypertension, smoking, and alcohol habits as well as for clinical parameters including body-mass index, waist-hip ratio, ankle-brachial index, and ejection fraction. All patients underwent coronary angiography and were evaluated for severity of coronary artery disease (based on number of vessels involved) and complexity of coronary angiographic lesions (measured by computer-assisted Syntax score calculator). The collected data were analyzed to determine the role of cardiovascular risk factors and clinical parameters as predictors of complexity and severity of coronary artery disease. Results: A total of 211 patients (mean age: 54.64 ± 9.9 years; 81% males) with coronary artery disease were analyzed. Findings revealed that diabetes mellitus (p < 0.001), hypertension (p < 0.001), smoking habits (p = 0.036), and low ankle-brachial index (p < 0.001) were independent predictors of complex coronary artery disease as measured by Syntax score. Significant associations were also evident between severity of coronary artery disease and diabetes mellitus (p < 0.001), hypertension (p < 0.001), and ankle-brachial index (p < 0.001). Conversely, other cardiovascular risk factors including body-mass index, alcohol habits, wait-hip ratio, and ejection fraction did not exhibit significant associations with severity and complexity of coronary artery. Conclusions: The early diagnosis of coronary artery can be predicated by evaluating diabetes, hypertension, and smoking habits in patients presenting with acute coronary syndrome. In addition, ankle-brachial index can be used as an effective non-invasive bedside tool, as an al-N. K. Cheruku et al. 839 ternative to Syntax score, in predicting the severity and complexity of coronary artery disease.

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“…10 In addition, ABI < 0.90 is associated with a worse cardiovascular prognosis and increased all-cause mortality. [11][12][13][14][15] Although ABI is useful for detecting PAD, its validity in predicting CAD is not well established.…”

Section: Resultsmentioning

confidence: 99%

Índice Tornozelo-Braquial como Preditor de Doença Coronariana Significativa em Pacientes Submetidos à Angiografia Coronária

Sabedotti¹,

Sarmento‐Leite²,

Quadros³

2014

Rev. Bras. Cardiol. Invasiva

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Background:The ankle-brachial index is a simple and effective tool for diagnosing peripheral artery disease, but has not been validated for the diagnosis of coronary artery disease. The aim of this study was to evaluate the ability of the ankle-brachial index to predict coronary artery disease in patients undergoing coronary angiography. Methods: Patients with clinical suspicion of coronary artery disease and indication for coronary angiography were prospectively evaluated. Significant coronary artery disease was defined as the presence of stenosis > 70% of at least one major epicardial coronary artery or any of their major branches. A ROC curve was developed to define the ankle-brachial index cutoff that best predicts coronary artery disease. Results: A total of 312 patients were evaluated: mean age was 57 ± 11 years and 50% were male. One hundred and sixteen (37.2%) patients had significant coronary disease. Ankle-brachial index measurement in these patients was significantly lower than in those without coronary artery disease (0.88 ± 0.14 vs. 0.96 ± 0.87; p < 0.01). Ankle-brachial index < 0.87 showed a sensitivity of 31%, specificity of 95.4%, positive predictive value of 75.9% and negative predictive value of 71.6%. The area under the ROC curve was 0.73 (95% confidence interval of 0.67-0.79). Conclusions: Ankle-brachial index < 0.87 had a high specificity to predict significant coronary disease. Considering its low cost and ease of use, measurement of ankle-brachial index may be incorporated to daily clinical practice to help diagnose significant coronary artery disease.

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Ankle-brachial index as a predictor of coronary disease events in elderly patients submitted to coronary angiography

Cited by 19 publications

References 22 publications

Association Between Ankle-Brachial Index and Coronary Lesions Assessed by Coronary Angiography

Association Between Ankle-Brachial Index and Coronary Lesions Assessed by Coronary Angiography

Analysis of Ankle-Brachial Index, Waist-Hip Ratio, Ejection-Fraction, Obesity, Smoking, Alcohol Habits, Diabetes and Hypertension as Independent Predictors of Complexity and Severity of Coronary Artery Disease

Índice Tornozelo-Braquial como Preditor de Doença Coronariana Significativa em Pacientes Submetidos à Angiografia Coronária

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