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Is the ankle-brachial index a useful screening test for subclinical atherosclerosis in asymptomatic, middle-aged

Rachael A Wyman1, Jon G Keevil, Kjersten L Busse

  • 1University of Wisconsin School of Medicine and Public Health, Division of Cardiovascular Medicine, Madison, Wis, USA.

WMJ : Official Publication of the State Medical Society of Wisconsin
|October 18, 2006
PubMed

Insights

The ankle-brachial index (ABI) is not a sensitive screening tool for detecting subclinical atherosclerosis in asymptomatic middle-aged individuals, despite current recommendations for cardiovascular risk prediction.

Area of Science:

  • Vascular Medicine
  • Cardiovascular Risk Assessment

Background:

  • Ankle-brachial index (ABI) is recommended for cardiovascular risk screening in individuals aged 50 and older.
  • Limited data exists on ABI's utility in patients referred for non-invasive cardiovascular risk testing.

Purpose of the Study:

  • To evaluate the ankle-brachial index (ABI) as a screening tool for subclinical atherosclerosis.
  • To assess ABI's effectiveness in asymptomatic individuals referred for non-invasive cardiovascular risk assessment.

Main Methods:

  • 493 asymptomatic patients without known atherosclerotic vascular disease were included.
  • Patients underwent ABI measurement and carotid intima-media thickness (CIMT) ultrasound.
  • ABI values were categorized as reduced (<0.9), normal (0.9-1.3), or increased (>1.3).

Main Results:

  • Only 1 patient (0.2%) had a reduced ABI.
  • ABI values showed a trend towards being higher with increased CIMT (P=0.051).
  • No significant differences in cardiovascular risk factors or carotid plaque were found among ABI groups.

Conclusions:

  • The ankle-brachial index (ABI) demonstrates low sensitivity for detecting subclinical atherosclerosis in asymptomatic middle-aged individuals.
  • Current recommendations for using ABI as a screening tool may not be effective in this population.
Abstract

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