Correlation between Ankle Brachial Index with Coronary Artery Disease and Gender

Abstract

Abstract Background Ankle brachial index (ABI) has been shown to be a specific and sensitive for the diagnosis of peripheral artery disease (PAD). Both PAD and coronary artery disease (CAD) are caused by atherosclerosis, which is a narrowing of the arteries due to the build-up of plaque and fatty material inside the lumen. The aim of our study is to find out the relation between ABI and coronary angiographic findings with cardiovascular risk factors and gender in patients admitted in a tertiary care center with a provisional diagnosis of CAD. Methods It is a cross-sectional observational study, in which patients admitted with suspected CAD are included. In this study, patient characteristics such as demographics, family history, past history of CAD, and other comorbidities were included, and also the risk factors for atherosclerosis such as hypertension, diabetes, dyslipidemia, and smoking history were enquired by using a predetermined proforma. In all study patients, ABI was measured prior to coronary artery angiogram (CAG). ABI ≤ 0.9 was considered as PAD, and ABI between 0.9 and 1.4 was considered as normal. Then, all patients included in the study underwent CAG. The results of the ABI reports were compared with the angiographic findings and atherosclerotic risk factors. Results In this study, 90 patients were included who were admitted for CAG. Twenty-two patients have ABI ≤ 1.09 among them, 9 patients have no CAD, and 13 patients have CAD on CAG. Sixty-eight patients have ABI ≥ 1.10, with 28 patients having no CAD and 40 patients having CAD. There is difference in the right and left mean ABI with right ABI less than left ABI, and it is statistically significant (p = 0.014). By binary logistic regression, the determinants of CAD are left ventricle ejection fraction (EF) and age, and ABI was not a predictor. In our study, out of 90 patients, only 1 had ABI < 0.9 (1.1%). Therefore, it is not worth doing ABI in all patients undergoing CAG to rule out peripheral vascular disease (PVD). This is true in male and female patients and even in the diabetics. In comparing male and female ABI, there is no significance between ABI in both the sexes. Conclusion This study findings concluded that ABI is not a useful method in assessing the risk factors and the severity of CAD in suspected patients. Only left ventricle EF and age were the predictors of the presence of CAD, and ABI was not a predictor. This study have shown the difference in the right and left mean ABI with right ABI less than left ABI, which is an important finding. This study has also shown the similar prevalence of ABI in both sexes. However, to make more accurate results on ABI (right vs. left), we should plan studies with larger sample size in future.