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Ankle brachial index most important to identify polyvascular disease in patients with non-ST elevation or

Birgitta Jönelid1, Nina Johnston1, Lars Berglund2

  • 1Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.

European Journal of Internal Medicine
|January 19, 2016
PubMed

Insights

Polyvascular disease (PvD) is common in acute myocardial infarction (MI) patients and often underdiagnosed. The ankle-brachial index (ABI) is a simple, predictive tool for identifying widespread atherosclerosis in these individuals.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Atherosclerosis is a systemic condition.
  • The prevalence of polyvascular disease (PvD) in acute myocardial infarction (MI) patients is not well-established.
  • This study investigates PvD prevalence and predictive clinical characteristics in ST-elevation (STEMI) and non-ST-elevation (NSTEMI) MI patients.

Purpose of the Study:

  • To determine the prevalence of polyvascular disease (PvD) in patients with acute myocardial infarction (MI).
  • To identify clinical characteristics that predict PvD in acute MI patients.
  • To assess the diagnostic utility of the ankle-brachial index (ABI) in identifying widespread atherosclerosis.

Main Methods:

  • The study included 375 patients with acute MI from the REBUS study.
  • Atherosclerotic changes were assessed in three arterial beds: coronary angiography, carotid ultrasound, and ABI.
  • PvD was defined as atherosclerosis in all three arterial beds.

Main Results:

  • Polyvascular disease (PvD) was present in 13.8% of acute myocardial infarction (MI) patients, with no significant difference between STEMI and NSTEMI.
  • Predictors of PvD included age, diabetes, prior peripheral artery disease (PAD), and female gender.
  • The ankle-brachial index (ABI) demonstrated high specificity (92.4%) and a positive predictive value of 68.4% for PvD.

Conclusions:

  • Polyvascular disease (PvD) is frequently underdiagnosed in patients with acute myocardial infarction (MI).
  • The ankle-brachial index (ABI) is a valuable and simple tool for predicting widespread atherosclerosis in MI patients.
  • Early identification and management of PvD in MI patients are crucial for improving outcomes.
Abstract

Keywords:
ABICarotid arteriesMyocardial infarctionPeripheral artery diseasePolyvascular disease

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