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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
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Ankle-Brachial Index in Addition to Stress Testing in Patients Who Presented With Chest Pain and 1-Year Major

Amir Lotfi1, Muhammad Shakoor1, Mashrafi Ahmed1

  • 1From the Department of Medicine, University of Massachusetts Medical School, Baystate.

Critical Pathways in Cardiology
|November 15, 2019
PubMed

Insights

Adding ankle-brachial index (ABI) to stress tests improves risk stratification for chest pain patients. Abnormal ABI or stress tests increase major cardiovascular events (MCE), with both indicating the highest risk.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Testing

Background:

  • Chest pain is a frequent emergency department presentation with limited long-term risk stratification.
  • Current methods may not fully identify patients at risk for major cardiovascular events (MCE).

Purpose of the Study:

  • To evaluate the utility of the ankle-brachial index (ABI) combined with stress testing for risk stratification in patients presenting with chest pain.
  • To assess long-term cardiovascular outcomes in this patient cohort.

Main Methods:

  • A prospective cohort study enrolled 348 patients with chest pain, normal biomarkers, and unchanged ECG.
  • All participants underwent both an ankle-brachial index (ABI) measurement and a cardiovascular stress test.

Main Results:

  • An abnormal ABI was associated with a 2-fold increased likelihood of an abnormal stress test (OR=2.03).
  • Patients with both normal ABI and normal stress tests had the lowest 1-year MCE incidence (8.2%).
  • Abnormal ABI and/or stress tests were associated with increased adjusted 1-year MCE risk compared to the low-risk group.

Conclusions:

  • Either an abnormal stress test or an abnormal ABI independently suggested increased 1-year MCE risk.
  • The combination of abnormal stress test and abnormal ABI indicated the highest risk for MCE.
  • Integrating ABI into stress testing protocols may enhance cardiovascular risk stratification for patients with chest pain.
Abstract

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