Abstract
prevalence of Coronary Artery Disease (CAD) was 75%, whereas in 118 age-matched and gender-matched patients with a normal ABI, the prevalence of CAD was 29% [6]. The prevalence of aortic valve calcium or mitral annular calcium was also higher in the patients with a decreased ABI (69%) than in the patients with a normal ABI (36%) [6]. In 279 men and women, mean age 71 years, with documented PAD with a low ABI and in 218 men and women, mean age 70 years, without PAD with a normal ABI undergoing coronary angiography for suspected CAD, the prevalence of obstructive PAD was significantly higher in patients with PAD (98%) than in patients with a normal ABI (81%) [7]. The prevalence of 3 or 4-vessel obstructive CAD was also significantly higher in patients with PAD (63%) than in patients with a normal ABI (11%) [7]. In 273 patients, mean age 71 years, with CAD, the lower the ABI, the higher the prevalence of 3-vessel or 4-vessel CAD [8]. Patients with PAD and CAD have more extensive and calcified coronary atherosclerosis, constrictive arterial remodeling, and greater disease progression [9]. The prevalence of PAD increases with age.The prevalence of PAD diagnosed by ABI was 16% in 360 men and 13% in 306 women aged 60 years [10]. Criqui et al. [11] showed that the prevalence of PAD diagnosed by ABI was 5.6% in persons aged 38 to 59 years, 15.9% in persons aged 60 to 69 years old, and 33.8% in persons aged 70 to 82 years old. In the Cardiovascular Health Study, PAD diagnosed by a low ABI was present in 13.9% of 2,214 men aged ≥ 65 years and in 11.4% of 2,870 women aged ≥ 65 years without cardiovascular disease [12]. In the Rotterdam Study, PAD diagnosed by ABI was present in 16.9% of 2,589 men aged ≥ 55 years and in 20.5% of 3,861 women aged ≥ 55 years [13]. The prevalence of PAD in 6,979 men and women, mean age 69 years, screened for PAD by an ABI because they were aged 70 years or older or because they were aged 50-69 years with a history of cigarette smoking or diabetes mellitus was 29% [14]. Among these patients with PAD, classic intermittent claudication was present in only 11% [14]. In the MESA (Multi-Ethnic Study of Atherosclerosis) study, of 6,674 men and women aged 45 to 84 years, 806 patients (12.1%) had an ABI <1.0, and 110 patients (1.7%) had an ABI of ≥ 1.4 [4].
Highlights
The preferred method to calculate the Ankle-Brachial Index (ABI) for the diagnosis of Peripheral Arterial Disease (PAD) is to measure by the Doppler method the systolic pressures of the left and right brachial arteries in addition to the dorsalispedis and posterior tibial arteries in each leg [1,2]
The ABI should be used as the first-line non-invasive test for diagnosing PAD [2]
An ABI ≤ 0.90 should be considered the threshold for confirming the diagnosis of lower extremity PAD [2]
Summary
The preferred method to calculate the Ankle-Brachial Index (ABI) for the diagnosis of Peripheral Arterial Disease (PAD) is to measure by the Doppler method the systolic pressures of the left and right brachial arteries in addition to the dorsalispedis and posterior tibial arteries in each leg [1,2]. In 273 patients, mean age 71 years, with CAD, the lower the ABI, the higher the prevalence of 3-vessel or 4-vessel CAD [8].
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