ANKLE/BRACHIAL INDEX AS A PREDICTOR OF CORONARY ARTERY DISEASES IN DIABETIC PATIENTS: WHAT IS THE BEST CUTOFF POINT?

Abstract

Background- Cardiovascular diseases are the main cause of death in diabetic patients. ‎Various studies have shown simultaneous involvement of coronary artery disease ‎along with peripheral artery diseases (PAD).‎ ‎<br />‎ The aim of this study is to evaluate the ability of Ankle/Brachial Index (ABI) to ‎foretell the possibility of ischemic heart diseases in diabetic patients<br />‎ ‏.‏ Methods- The diabetic patients, who visited our diabetes research center between May ‎‎2000 and May 2001 and were, confirmed diabetics for the previous 2 or more years, ‎were enrolled in the study. The ABI was calculated for all of the patients and their Demographic specifications and ischemic heart disease risk factors were recorded. All ‎the patients referred to perform an exercise test according to the Bruce protocol. <br />‎ Results- Four hundred ninety- seven patients (52.4%) were women, and 451 patients ‎‎(47.6%) were men. The mean age was 55.25 ± 10.08 years. 10.2%of the patients had ‎an ABI <_ 1. ABI showed a significant reduction in patients > 60 years (P = 0.02). ‎Two hundred thirty- eight patients were in group I (25.1 %), 625 patients in group II ‎‎(65.9 %) and 85 patients in group III (9%). 52.8% of the 125 patients in Group I, ‎‎19.6% of the 107 patients in group II and 44.7% of the 47 patients in Group III had ‎positive exercise test. I, II (P=~ 0.00) - II, III (P = 0.05).A total of 108 patients out of ‎the 279 patients had positive exercise test (38%) and most of them were from groups I ‎&III. 72.2% of group I and 52.5% of group II had high blood pressure (P - 0.00‎‏(.‏ ‎<br />‎ Conclusion- Ankle Brachial Index (ABI) with cutoff point 51.1 & >_ 1.4 is an ‎independent predictor of coronary artery diseases in diabetic patients, especially in ‎those who are hypertensive (Iranian Heart Journal 2002, 2003; 3(4) & 4(1): 47-55‎‏).