Ankle-Brachial Index as a Prognostic Factor and Screening Tool in Coronary Artery Disease: Does it Work?
Background: Given the lack of consistency in the literature regarding the reliability of the ankle-brachial index (ABI) as a valid screening tool and an independent risk indicator of cardiovascular events and mortality, we compared it with angiography as a reference standard test. Methods: This cas...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2015-10-01
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| Series: | Journal of Tehran University Heart Center |
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| Online Access: | https://jthc.tums.ac.ir/index.php/jthc/article/view/352 |
| _version_ | 1818530426704101376 |
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| author | Zinat Nadia-Hatmi Soheila Dabiran Ahmad Sabouri-Kashani Zeynab Heidarzadeh Zeynab Darvishi Maedeh Raznahan |
| author_facet | Zinat Nadia-Hatmi Soheila Dabiran Ahmad Sabouri-Kashani Zeynab Heidarzadeh Zeynab Darvishi Maedeh Raznahan |
| author_sort | Zinat Nadia-Hatmi |
| collection | DOAJ |
| description | Background: Given the lack of consistency in the literature regarding the reliability of the ankle-brachial index (ABI) as a valid screening tool and an independent risk indicator of cardiovascular events and mortality, we compared it with angiography as a reference standard test.
Methods: This case-control study, conducted between 2010 and 2011 in Tehran Heart Center, recruited 362 angiographically confirmed cases of coronary artery disease (CAD) and 337 controls. A standard protocol was used to measure the ABI and different CAD risk factors.
Results: A low ABI had specificity of 99.7%, positive predictive value of 95.8%, negative predictive value of 49.8%, sensitivity of 64%, likelihood ratio of 24.07, and odds ratio (OR) of 22.79 (95%CI: 3.06-69.76). The role of the associated risk factors was evaluated with OR (95%CI), with the variables including gender 3.15 (2.30-4.30), cigarette smoking 2.72 (1.86-3.99), family history 1.72 (1.17-2.51), diabetes 1.66 (1.15-2.4), and dyslipidemia 1.38 (1.02-1.88). In a multivariate model, the following variables remained statistically significantly correlated with CAD [OR (95%CI)]: ABI 13.86 (1.78-17.62); gender 3.69 (2.43- 5.58); family history of CAD 2.18 (1.41-3.37); smoking 1.69 (1.08-2.64); age 1.04 (1.02-1.06).
Conclusions: A low ABI had specificity of 99.7%; however, because of its low sensitivity (64%), we should consider CAD risk factors associated with a low ABI in order to use it as a first-line screening test. |
| first_indexed | 2024-12-11T17:19:32Z |
| format | Article |
| id | doaj.art-eea72cd31413443bbb0e31524bcb7534 |
| institution | Directory Open Access Journal |
| issn | 1735-8620 2008-2371 |
| language | English |
| last_indexed | 2024-12-11T17:19:32Z |
| publishDate | 2015-10-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Tehran University Heart Center |
| spelling | doaj.art-eea72cd31413443bbb0e31524bcb75342022-12-22T00:57:12ZengTehran University of Medical SciencesJournal of Tehran University Heart Center1735-86202008-23712015-10-0194348Ankle-Brachial Index as a Prognostic Factor and Screening Tool in Coronary Artery Disease: Does it Work?Zinat Nadia-Hatmi0Soheila Dabiran1Ahmad Sabouri-Kashani2Zeynab Heidarzadeh3Zeynab Darvishi4Maedeh Raznahan5Nourafshar Hospital, Tehran University of Medical Sciences, Tehran, Iran.Curriculum Development Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Research Deputy Directorship of Medical Faculty, Tehran, Iran.Background: Given the lack of consistency in the literature regarding the reliability of the ankle-brachial index (ABI) as a valid screening tool and an independent risk indicator of cardiovascular events and mortality, we compared it with angiography as a reference standard test. Methods: This case-control study, conducted between 2010 and 2011 in Tehran Heart Center, recruited 362 angiographically confirmed cases of coronary artery disease (CAD) and 337 controls. A standard protocol was used to measure the ABI and different CAD risk factors. Results: A low ABI had specificity of 99.7%, positive predictive value of 95.8%, negative predictive value of 49.8%, sensitivity of 64%, likelihood ratio of 24.07, and odds ratio (OR) of 22.79 (95%CI: 3.06-69.76). The role of the associated risk factors was evaluated with OR (95%CI), with the variables including gender 3.15 (2.30-4.30), cigarette smoking 2.72 (1.86-3.99), family history 1.72 (1.17-2.51), diabetes 1.66 (1.15-2.4), and dyslipidemia 1.38 (1.02-1.88). In a multivariate model, the following variables remained statistically significantly correlated with CAD [OR (95%CI)]: ABI 13.86 (1.78-17.62); gender 3.69 (2.43- 5.58); family history of CAD 2.18 (1.41-3.37); smoking 1.69 (1.08-2.64); age 1.04 (1.02-1.06). Conclusions: A low ABI had specificity of 99.7%; however, because of its low sensitivity (64%), we should consider CAD risk factors associated with a low ABI in order to use it as a first-line screening test.https://jthc.tums.ac.ir/index.php/jthc/article/view/352Ankle brachial index • Coronary artery disease • Risk assessment |
| spellingShingle | Zinat Nadia-Hatmi Soheila Dabiran Ahmad Sabouri-Kashani Zeynab Heidarzadeh Zeynab Darvishi Maedeh Raznahan Ankle-Brachial Index as a Prognostic Factor and Screening Tool in Coronary Artery Disease: Does it Work? Journal of Tehran University Heart Center Ankle brachial index • Coronary artery disease • Risk assessment |
| title | Ankle-Brachial Index as a Prognostic Factor and Screening Tool in Coronary Artery Disease: Does it Work? |
| title_full | Ankle-Brachial Index as a Prognostic Factor and Screening Tool in Coronary Artery Disease: Does it Work? |
| title_fullStr | Ankle-Brachial Index as a Prognostic Factor and Screening Tool in Coronary Artery Disease: Does it Work? |
| title_full_unstemmed | Ankle-Brachial Index as a Prognostic Factor and Screening Tool in Coronary Artery Disease: Does it Work? |
| title_short | Ankle-Brachial Index as a Prognostic Factor and Screening Tool in Coronary Artery Disease: Does it Work? |
| title_sort | ankle brachial index as a prognostic factor and screening tool in coronary artery disease does it work |
| topic | Ankle brachial index • Coronary artery disease • Risk assessment |
| url | https://jthc.tums.ac.ir/index.php/jthc/article/view/352 |
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