Ankle/brachial index as a predictor of coronary artery diseases in diabetic patients: What is the best cutoff point?
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). The aim of this study is to evaluate the ability of Ankle/brachial index (ABI) to foretell the possibility of ischemic heart disease in diabetic patients. 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”. Results: 497 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). 238 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). Conclusion: Ankle/brachial index (ABI) with cutoff point?1.1 & ?1.4 is an independent predictor of coronary artery disease in diabetic patients, especially in those who are hypertensive.