Agreement between ABI [ankle brachial index] and USD [ultrasound duplex scanning] in symptomatic peripheral arterial disease patients

Atherosclerosis of the peripheral arteries occurs in 12% of individuals at 65 years of age or older. At least 28% of these patients suffer from coronary heart diseases and 10% of them are afflicted with cerebrovascular diseases. To calculate the agreement between two diagnostic tests for peripheral arterial disease [PAD], namely ankle brachial index [ABI] and ultrasound duplex scanning [USD]. Forty symptomatic PAD patients were enrolled in this study, and their demographic characteristics, risk factors, and symptoms as well as their ABI and USD measurements were recorded. On the basis of the symptoms and ABI and USD findings, the patients were divided into four groups and comparisons were made between them so that the associations between the findings could be analyzed. The study population included 32 [80%] men at a mean age of 62.9+12.8 years [26-90]. Smoking [75%] and hypertension [100%] were the most common risk factors in the men and women, respectively, followed by diabetes in both genders. Whereas the agreement between ABI and USD findings in the men was significant [Kappa=0.28, P=0.02], it was not significant [Kappa=-0.91, P=0.68] in the women. Additionally, there was a significant correlation between symptoms and ABI findings [Kappa=0.21, P=0.04], while that between symptoms and USD measurements was not significant [Kappa=0.09, P=0.3]. The correlation between ABI findings and symptoms, especially in the men, was better than that between ABI findings and USD measurements. ABI could, therefore, be considered an appropriate tool for the initial screening of arterial stenosis and lower extremity circulation

Ankle/Brachial Index [ABI] as a predictor test for coronary artery diseases in diabetic patients: What is the best cut off point?

The aim of this study is to evaluate the ability of Ankle/Brachial Index [ABI] [A sensitive and specific test for detection of PAD] to foretell the possibility of ischemic heart diseases in diabetic patients. 948 patients with confirmed diabetes since 2 or more years were enrolled in the study. 497 patients [52.4%] were women, and 451 patients [47.6%] were men. The mean age was 55.25 years. 10.2% of the patients had an ABI=<1. ABI showed a significant reduction in patients >60 years. [P value=0.02] 56% of participants had high blood pressure. The patients were divided into 3 groups: Group I: 238 patients with ABI<=1.1, [25.1%], Group II: 625 patients with ABI between 1.1 and 1.4 [65.9%], Group III: 85 patients with ABI>=1.4 [9%]. 52.8% of 125 patients in Group I, 19.6% of 107 patients in Group II, and 44.7% of 47 patients in Group III had positive exercise test. [P value I, II=0.00- P value II, III=0.05]. A total of 108 patients from among the 279 patients had positive exercise test [38%], and most of them were from groups III and I. 72.2% of group I, and 52.5% of group II had high blood pressure. [P value= 0.00]. Positive exercise test became positive significantly more in patients with ABI /= 1.4 [both hypertensive and normotensive] than those with 1.1 ABI<1.4. [P value=0.001 and 0.003]. Ankle/Brachial Index [ABI] with cut off point /= 1.4 is a predictor for coronary artery diseases in diabetic patients specially in those who are hypertensive