CORRELATION OF ABNORMAL ANKLE-BRACHIAL INDEX WITH SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS HOSPITALIZED FOR ACUTE MYOCARDIAL INFARCTION

Abstract

Objective: The coexistence of peripheral artery disease in patients with coronary artery disease (CAD) has been associated with a poor cardiovascular outcome. The aim of this study was to assess the usefulness of ankle-brachial index (ABI) assessment in predicting the severity of coronary artery disease in patients with acute myocardial infraction (AMI). Design and method: We studied 101 patients [77.2% male; mean age 60.9 years; 63.4% hypertensives; 24.8% with diabetes mellitus (DM)] who were hospitalized because of ST-elevation MI (STEMI, 51.5%) and Non-ST–elevation MI (NSTEMI). All patients underwent baseline estimation of clinical and laboratory parameters during their hospitalization. The ABI was measured according to established methodology using a certified automated device and abnormal ABI was defined as a value <0.9. Severity of CAD was estimated by the number of affected main vessels. Results: In the entire population, mean ABI was 1.11 ± 0.19, while 15.8% of patients had abnormal ABI. NSTEMI patients compared to those with STEMI demonstrated relatively lower ABI (1.07 ± 0.18 vs 1.12 ± 0.16; p = 0.144) and had more often abnormal ABI (22.4% vs 9.6%; p = 0.103). Using univariate analysis in the entire population, severity of CAD was correlated with age (r = 0.133; p = 0.053), history of DM (r = 0.225; p = 0.01), abnormal ABI (r = 0.242; p = 0.015) and ABI value (r = 0.214; p = 0.029). In multivariate regression models, both ABI value (b = 0.212; p = 0.037) and abnormal ABI (b = 0.224; p = 0.036) remained significant predictors of CAD severity independently of gender, age, DM, smoking, low density lipoprotein (LDL-C), 24-h systolic BP and the type of MI. Conclusions: Estimation of ABI managed to predict multivessel CAD in patients with AMI. These findings in patients with ACS scheduled to undergo a cardiac catheterization may raise the suspicion of advanced disease, alerting the need for more aggressive diagnostic and therapeutic strategies.