Objectives Peripheral Arterial Disease (PAD) is a common manifestation of systemic atherosclerosis. The symptoms most often appears on atherosclerotic disease of the lower extremities is intermittent claudication, but most people just show up without symptoms. A noninvasive diagnosis to estimate and detect the severity of PAD is the ankle-brachial pressure index (ABI). Several studies have shown that ABI correlates with severity of coronary artery disease by angiography. Resnick et al identified nearly doubled individuals who suffer from CHD in the category of high ABI (> 1.3), so this shows that individuals with high ABI is not uncommon and the health effects of high ABI may be greater than the low ABI. Resnick et al also stated value of ABI > 1.40 predicted mortality with the same power with ABI <0.90 with the form a U-shaped curve association between high and low ABI with cardiovascular mortality event.
Methods A cross-sectional prospective.Statistical analysis was performed using SPSS 15.0 for Windows. All data were expressed by mean ± SD. Univariate analysis of the relationship between each potential risk factor with ABI performed with standard regression techniques. ABI relationship with the extent of coronary artery disease (Gensini score) assessed by linear regression analysis.
Results ABI examined in 104 patients with a working diagnosis of stabil or unstable angina examined for elective coronary angiography, and did not have any symptom of intermittent claudication. Patients with renal impairment with creatinine levels ≥ 2 mg/dl were excluded from the study to avoid confounding factors. In our study found the majority of subjects were examined lipid profile and blood sugar are within normal limits. Our study did not evaluate the anti-cholesterol agent, anticoagulant and antiplatelet drugs. While 41.3% of our study subjects had a history of diabetes mellitus. All subjects measured height and weight and obtained the majority (56%) had a large excess of nutritional status (obese) and only 18% of normal nutritional status. In the univariate analysis found gender, smoking, diabetes mellitus and high ABI values (> 1.3) and total cholesterol had a significant relationship to the incidence of CHD. Low ABI values (<0.9) were not statistically significantly associated with CHD events even though all patients with a low ABI had significant coronary artery stenosis, due to the low ABI population in this study was very small (2.9%). Although sex on univariate analysis had a significant relationship to the incidence of CHD, but on multivariate analysis gender does not appear to be factors that influence the incidence of CHD due correlations sex with CHD events was very weak.
Conclusions CHD population with a low ABI values (< 0.9) very small (2.9%) while the population of high ABI values (> 1.3) were common. Normal ABI values (0.9-1.3) does not rule out the possibility of CHD. ABI values were high (> 1.3) had a significant correlation to predict the likelihood and severity of coronary heart disease.