Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus: Correlating Ankle Brachial Pressure Index with Coronary Angiography

Abstract

Diabetes mellitus (DM) affects over 366 million people worldwide ; this figure is expected to rise to 522 million by the year 2030. The macrovascular complications of diabetes cause morbidity and mortality. Ankle brachial pressure index (ABPI) is a simple non-invasive tool which may indicate atherosclerotic changes in the blood vessels. It is useful in diagnosis of peripheral artery disease (PAD), and is also an indicator of increased cardiovascular morbidity and mortality. Previous studies have reported a correlation between ABPI and coronary artery disease (CAD). Despite the well-established association between diabetes and coronary artery disease, the role of ABPI in predicting the presence and severity of CAD in diabetics has not been proven. The study was done to find whether there was an association between ABPI and coronary angiogram in diabetics. Materials and Methods: This was a cross sectional study that included 100 patients of Diabetes Mellitus who had undergone a coronary angiogram during the current admission. All coronary angiograms were evaluated by a cardiologist. The ABPI was measured according to the standardized protocol before the patients underwent the coronary angiogram procedure. Results: Out of the patients, 4 patients (4.3%) had ABPI < 0.9 out of which 2 (50%) had double vessel disease and 2 (50%) had triple vessel disease. Conclusion: Though all patients with abnormal ABPI had CAD as assessed by CAG, not all patients with abnormal CAG had abnormal ABPI. Thus the utility of ABPI as a surrogate marker in screening of CAD is limited.