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Published on: October 22, 2014
Abnormal ankle brachial index and the presence of significant coronary artery disease
Fuad Hakeem1, Saulat Siddique, Qazi A Saboor
1Department of Cardiology, Sheikh Zayed Hospital, Lohare. fuadhakeem@yahoo.com
Insights
This study found no direct link between abnormal ankle-brachial index (ABI) and significant coronary artery disease (CAD). However, a trend suggests increased CAD risk with lower ABI values.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- The ankle-brachial index (ABI) is a non-invasive test used to assess peripheral artery disease.
- Coronary artery disease (CAD) and peripheral artery disease share common risk factors.
- Investigating the association between ABI and CAD can improve cardiovascular risk stratification.
Purpose of the Study:
- To determine the association between an abnormal ankle-brachial index (ABI) and the presence of significant coronary artery disease (CAD).
Main Methods:
- A cross-sectional, observational study involving 41 patients undergoing coronary angiography.
- Ankle-brachial index (ABI) was calculated before coronary angiography.
- Patients with documented peripheral arterial disease were excluded.
Main Results:
- Only 3 patients (7.31%) with an ABI < 0.9 had triple-vessel disease.
- No statistically significant association was found between ABI < 0.9 and triple-vessel disease (p=0.07).
- A log-linear relationship was observed between ABI and CAD risk.
Conclusions:
- The study did not establish a direct association between ABI and significant CAD.
- However, ABI values below 1.0 were associated with increased CAD risk.
- ABI values above 1.0 showed a declining trend in CAD risk.
Objective:
To determine the association between an abnormal ankle brachial index (ABI) and the presence of significant coronary artery disease (CAD) on coronary angiography.
Study Design:
Cross-sectional, observational study.
Place And Duration Of Study:
The study was carried out at Sheikh Zayed Hospital, Lahore, from July to October 2007.
Methodology:
A series of 41 patients undergoing coronary angiography in Sheikh Zayed Hospital were selected and their ABI were calculated before the diagnostic coronary angiography. ABI calculations and coronary angiography reporting were done by separate individuals and data was analysed using SPSS 12.0. All patients undergoing diagnostic coronary angiography were included in the study except for those having peripheral arterial disease documented by lower extremity revascularization, lower extremity ulceration and lower extremity amputation. Proportion were compared using chi-square test with significance at p < 0.05.
Results:
Out of the 41 patients 31 male (76%) and 10 female (24%), 3 patients (7.31%) had ABI < 0.9 and all 3 had triple vessel disease. Ten patients (24%) had ABI 0.91-0.99 and 2 (20%) of them had single vessel disease. Two (20%) had double vessel disease and 6 (60%) had triple vessel disease. Twenty four patients (58%) had ABI of 1.00-1.28 and 8 (33%) of these had single vessel disease, 3 (12%) had double vessel disease and 13 (55%) had triple vessel disease, while 4 patients had normal coronaries. A total of 22 patients were found to have triple vessel disease and only 3 (13.6%) of these 22 patients had an ABI < 0.9 which is statistically not significant (p=0.07).
Conclusion:
This study was not able to establish a direct association between ABI and significant CAD as only 3 patients out of 22 with triple vessel disease had an ABI < 0.9. However, an approximately log linear relationship was noted between ABI and CAD risk which means that not only the average CAD risk increased exponentially at values < 1.0 but also that the CAD risk continued to decline as ABI values increased above 1.0.
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