Markers for predicting Coronary Artery Disease in Patients undergoing Coronary Angiography - by use of Ankle-Brachial Index - adescriptive study in rural tertiary care centre (Rajarajeswari Heart Centre)

Dr Rajiv Girdhar, Assistant Professor in Cardiology Department in Rajarajeswari Medical College and Hospital, Bangalore
2020 Journal of Medical Science And clinical Research  
Objectives: The Ankle-Brachial index (ABI) is a highly effective tool for diagnosing peripheral artery disease. Peripheral arterial disease (PAD) is frequently under-diagnosed condition in the clinical setup which leads to a lack of opportunity in detection of subjects at a high risk for cardiovascular (CV) death. But use of the Ankle-Brachial index (ABI) till date has not been validated for the diagnosis of coronary artery disease. Aim of this Study: To evaluate the ability of the
more » ... of the ankle-brachial index in prediction of coronary artery disease in patients undergoing coronary angiography. Methods: Patients with clinical suspicion of coronary artery disease and indication for coronary angiography were prospectively evaluated. Significant coronary artery disease was defined as the presence of stenosis >70% of at least one of the major epicardial coronary artery or any of their major branches. A ROC curve was developed to define the ankle-brachial index cutoff that best predicts coronary artery disease. Results: A total of 51 patients were evaluated: mean age was 56 ± 12 years and 55% of them were males. Ninteen (37.2%) patients had significant coronary disease. Ankle-brachial index measurement in these patients was significantly lower than in those without coronary artery disease (0.78 ± 0.14 vs. 0.86 ± 0.87; p <0 .01). Ankle-brachial index <0.87 showed a sensitivity of 31%, specificity of 96.4%, positive predictive value of 76.9% and negative predictive value of 71.6%. The area under the receiver operating characteristic (ROC) curve was 0.73 (95% confidence interval of 0.67-0.79). Conclusions: ABI values ≤ 0.87 showed high specificity to predict significant coronary artery disease.
doi:10.18535/jmscr/v8i5.61 fatcat:mkkusyjkmngunfmtuv237gjepm