Ankle-arm index as a predictor of lesion morphology and risk classification for coronary artery disease undergoing angioplasty
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Published on: September 22, 2020
Shih-Tai Chang1, Chien-Lung Chen, Chi-Ming Chu
1Division of Cardiology, Chiayi Chang Gung Memorial Hospital, Pu-TZ City, Chai Yi Hsien, Taiwan. cst1234567@yahoo.com.tw
Insights
Low ankle-arm index (AAI) predicts coronary artery disease (CAD) severity. This study found AAI is a significant predictor of lesion site, complexity, and morphology in patients undergoing angiography.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Low ankle-arm systolic blood pressure index (AAI) correlates with cardiovascular risk factors.
- Established hazards of coronary artery disease (CAD) exist, but AAI's relation to CAD severity is unknown.
Purpose of the Study:
- To investigate the relationship between ankle-arm index (AAI) and coronary artery disease (CAD) severity.
- To determine if AAI can predict CAD severity.
Main Methods:
- 477 patients underwent coronary angiography and AAI measurements.
- Patients were divided into a study group (AAI < 0.9) and a control group (AAI >= 0.9).
Main Results:
- The study group (low AAI) had significantly more complex lesions and specific lesion morphologies compared to the control group.
- AAI was a significant independent predictor for lesion site, complex stenotic lesions (B2 or C), and lesion morphology.
- Odds ratios for AAI predicting lesion site, complex lesions, and morphology were 1.728, 2.880, and 2.71, respectively.
Conclusions:
- Ankle-arm index (AAI) is a valuable non-invasive tool.
- AAI can predict the severity of coronary artery disease (CAD).
Background:
Low ankle-arm systolic blood pressure index is strongly correlated with various cardiovascular risk factors. However, although the potential hazards of resulting coronary artery disease (CAD) are well established, no data is available regarding how ankle-arm index (AAI) and CAD severity are related.
Methods:
This study enrolled 477 patients and all patients underwent coronary angiography and AAI measurements. Based on AAI values, patients were divided into study (AAI value of <0.9, 126 patients) and control groups (AAI value of >or=0.9, 351 patients).
Results:
Among baseline characteristics, the study group showed a significantly older and higher female ratio than the control group. The presence of hypertension, diabetes mellitus (DM), current smoking status and LDL-cholesterol level differed significantly between these two groups. Mean number of lesions and target vessel involvement were significant different between the study and control group (2.6+/-1.1 vs. 1.9+/-1.0, p<0.0001; 2.0+/-0.8 vs. 1.6+/-0.7, p<0.0001). Percentages of lesion sites on ostial and proximal portions were markedly high in the study group than in the control group. Significant differences also emerged in the complex stenotic lesions (B2 or C) and lesion morphology (calcified, chronic total occlusion, irregular, bifurcation and diffuse) of these two groups. Multivariate logistic regression analysis, showed that AAI is a statistically significant independent predictor for lesion site, complex stenotic lesions and lesion morphology with Odds ratios (ORs) of, respectively, 1.728, 2.880 and 2.71.
Conclusions:
The AAI is a useful non-invasive tool for the prediction of CAD severity.
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