Ankle Brachial Index as a Predictor of Coronary Artery Disease in Diabetic Patients

Background: Coronary artery disease (CAD) due to atherosclerosis is an epidemic in India. The incidence of coronary artery disease has doubled during past three to four decades. The role of diabetes mellitus (DM) in relation to CAD was believed to be as important as CAD itself. Owing to the similar vasculopathy characteristics, patients with DM were frequently combined with Peripheral Artery Disease (PAD). However of outpatients, clinically suspected of having CAD, the relationship and interaction between DM and PAD remains unknown. Previous investigations have shown that ankle brachial index (ABI) is a quick and useful tool for assessing and evaluating the presence of peripheral arterial disease of the lower extremities. The aim of current study was to determine the relation between ABI with angiographic stenosis and major cardiovascular risk factors in type 2 DM patients with suspected CAD. Materials and methods: A cross sectional study was conducted at a tertiary care centre including 100 consecutive diagnosed cases of diabetes. CAD was diagnosed by a history of angina/ any past history or treatment for CAD/ ECG changes and 2 D echo findings and CAG. Ankle Brachial Index (ABI) was calculated for all patients by using Duplex Colour Doppler and ABI <0.9 was diagnosed as PVD. Statistical Analysis of data was done by using SPSS software ver. 21. Results: About 68.9% of the cases with established CAD proven by angiography had abnormal ABI while 64.1% of the cases with normal coronary angiography had an abnormal ABI thus predicting a future risk of CAD. Mean HbA1c and uric acid levels and number of cases with microalbuminuria was significantly higher among cases with CAD. About 92.9% of the cases with Triple vessel CAG had Positive ABI which was significantly more as compared to 68.0%, 66.7% and 47.8% of the cases who had Single, Normal and Double vessel CAG respectively. Conclusion: Ankle brachial index is a sensitive, non-invasive predictor of coronary artery disease in diabetic patients. It however needs other markers in association for better specificity for predicting CAD.