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