Ankle-brachial index as a predictor of significant coronary artery disease in patients with NSTE-ACS?

Abstract

The ankle-brachial index is a simple and effective tool for diagnosing peripheral artery disease, but has not been validated for predicting prognosis in coronary artery disease. The aim of this study was to evaluate the ability of the ankle-brachial index to predict significant coronary artery disease in patients with NSTE-ACS. Patients admitted for NSTE-ACS and indication for coronary angiography were prospectively evaluated, significant coronary artery disease was defined as the presence of stenosis > 70% of at least one major epicardial coronary artery or any of their major branches. A ROC curve was developed to define the ankle-brachial index cutoff that best predicts significant coronary artery disease. A total of 296 patients were evaluated: mean age was 62 ± 12 years and 58% were male. Two hundred and eighteen (73.6%) patients had significant coronary disease. Ankle-brachial index measurement in these patients was non significantly lower than in those without coronary artery disease (1.04 ± 0.17 vs. 1.07 ± 0.12; P = 0.262). The area under the ROC curve was 0.53 (95% confidence interval of 0.46–0.60). With these results, we cannot define an ankle-brachial index cut-off that best predicts significant coronary artery disease. In our study, the ankle-brachial index is not able to predict significant coronary artery disease in patients with NSTE-ACS.