CORRELATION OF ANKLE-BRACHIAL INDEX WITH SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS HOSPITALIZED FOR ACUTE MYOCARDIAL INFARCTION. (April 2021)

• Record Type: Journal Article
• Authors: Koumelli, A.; Tsioufis, K.; Konstantinou, K.; Mantzouranis, E.; Kasiakogias, A.; Dimitriadis, K.; Milk, A.; Konstantinidis, D.; Leontsinis, I.; Tousoulis, D.
• Is Part Of: Journal of hypertension. Volume 39(2021)e-Supplement 1
• Publication Date: 2021-04
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000744864.93652.28
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Ankle-brachial index (ABI) is an stablished predictor of cardiovascular events in different clinical setting including hypertension Purpose: To assess the usefulness of ABI evaluation for identifying multivessel CAD in patients with acute myocardial infraction (AMI). Design and method: We studied 101 patients [77.2% male; mean age 60.9 years; 63.4% hypertensives; 24.8% with diabetes mellitus (DM)] who were hospitalized because of ST-elevation MI (STEMI, 51.5%) and Non-ST–elevation MI (NSTEMI). All patients underwent baseline estimation of clinical and laboratory parameters during their hospitalization. The ABI was measured according to established methodology using a certified automated device and abnormal ABI was defined as a value <0.9. Severity of CAD was estimated by the number of affected main vessels. Results: In the entire population, mean ABI was 1.11 ± 0.17, while 15.8% of patients had abnormal ABI. NSTEMI patients compared to those with STEMI demonstrated a trend forlower ABI (1.07 ± 0.18 vs 1.12 ± 0.16; p = 0.144) and more often abnormal ABI (22.4% vs 9.6%; p = 0.103). Using univariate analysis in the entire population, severity of CAD was correlated with age (r = 0.133; p = 0.053), history of DM (r = 0.225; p = 0.01), ABI value (r = 0.214; p = 0.029) and abnormal ABI (r = 0.242; p = 0.015). In multivariate regression models, both ABI value (b = 0.258; p = 0.014) and abnormal ABI (b = 0.218; p = 0.036) remained significant predictors of CAD severity independently of gender, age, DM, smoking, low density lipoprotein (LDL-C), 24-h systolic blood pressure and the type of MI. Conclusions: An impaired ABI is associated with greater risk of multivessel CAD in patients with AMI. This finding in patients with acute coronary syndromes may thusraise the suspicion of advanced disease, alerting to the need for moreaggressive diagnostic and therapeutic strategies.