English

Abstract

BACKGROUND Peripheral arterial disease (PAD) is one of the macrovascular manifestations of systemic, diffuse atherosclerosis. Patients with acute myocardial infarction are at 3 - 5 times higher risk of developing associated PAD. Ankle Brachial Pressure Index (ABPI) is a simple, non-invasive test to diagnose peripheral arterial diseases in symptomatic cases. We wanted to assess the utility of an alternative formula for Ankle Brachial Pressure Index as a sensitive screening tool for asymptomatic peripheral arterial diseases in patients with acute myocardial infarction and cerebrovascular accident. METHODS This is a prospective observational study, recruiting eligible patients from medicine and cardiology outpatient department (OPD). Patients included were those with acute myocardial infarction (MI) or cerebrovascular accident (CVA). Sample size was calculated to be 257. ABPI was measured using a hand-held Doppler of 8 MHz and a standard sphygmomanometer. Statistical analysis was performed using SPSS software. RESULTS Alternate ABPI showed a mean value of 0.9 + / - 0.072. In the study population, 61.1 % were found to have abnormal ABPI i.e., less than 0.9, which is nearly two thirds of the population. Receiver operating characteristic curve (ROC) was plotted against ABPI for sensitivity and specificity for the co-morbidities considered in the study. It was found that the AUC (Area Under the Curve) was statistically significant for acute MI and acute CVA, with a fair positive correlation. CONCLUSIONS The alternative, ABPI is a good screening test for detecting asymptomatic PAD in patients with acute MI and CVA. However, further comparative studies are required to confirm the utility of the same in such patients, especially in a larger, varied population. KEY WORDS Ankle Brachial Pressure Index, Atherosclerosis, Peripheral Arterial Disease, Cardiovascular Diseases