Ankle Brachial Index as Predictor of Coronary Artery Lesion Severity in Patients with Suspected Stable Coronary Artery Disease

Abstract

Background: Atherosclerosis is a general process and can occur in coronary, peripheral, and aortic arteries. Traditional risk factors for atherosclerosis are gender, age, hypertension, diabetes, smoking, dyslipidemia, and family history. Atherosclerosis in the coronary arteries will develop into coronary artery disease (CAD). Angiography examination is the gold standard in CAD diagnosis. Lower extremity artery disease (LEAD) is part of peripheral artery disease (PAD) due to atherosclerosis and can be diagnosed using the ankle brachial index (ABI). The aim of this study was to predict the severity of coronary artery lesions in patients with suspected SCAD population with ABI.
Method: This was a analytical observational study using cross sectional research design. Data was taken consecutively from affordable populations at the polyclinic of RSUP Dr. Sardjito for 2 periods in May 2017-August 2017 and August 2018-October 2018. Examination of ABI was performed before patients underwent angiography and ABI was divided into low ABI (≤0.90) and normal ABI (0.91-1.40). SS measurements based on video angiography were divided into severe (SS> 22) and not severe (SS ≤22).Data were presented in categorical form and analyzed using SPSS 23. Confounding factors were then analyzed by bivariate test. If there was a confounding factor with a value of p <0.25, it was followed by a multivariate test.
Result: There were 35 subjects with low ABI and 71 subjects with severe lesions of 104 patients. The hypothesis test showed ABI increased the incidence of coronary lesion severity with PR 1.52 (1.21-1.93 with 95% CI) with a p value of 0.002. Bivariate tests show no confounding factors that increase the incidence of coronary lesion severity. Hypertension and dyslipidemia have a value of p <0.25 so multivariate analysis is performed. The results of multivariate analysis were only that ABI increase the incidence of coronary lesion severity (p= 0.004).
Conclusion: A low ABI value will increase the incidence of coronary atherosclerosis lesion by 1.52 times in patients with suspected SCAD