Use of Ankle-Brachial Index as a Predictor of Severity of Atherosclerosis

Objective: To demonstrate that low ABI is closely linked with the severity of atherosclerosis. Our secondary objective is to promote the awareness of screening and management of PAD Methods and results: A sample size of 230 participants was identified in Out Patient Department (OPD). 100 subjects were in control group with no more than one high risk factor, 100 in high risk asymptomatic group with 2 or >2 high risk factors or diabetes mellitus and 30 were in symptomatic group with manifest peripheral, coronary and/or cerebral arterial disease. Mean ABI of control group’s was1.0115±0.081 versus 0.9838±0.08 in high risk asymptomatic group and 0.9302±0.140 in symptomatic group (p<0.01).In control group 15 cases were PAD positive with their ABIs in the range of 0.71-0.90 versus high risk asymptomatic and symptomatic group where 43.8 and 40.6% cases were PAD positive with ABIs between 0.71-0.90 and <0.7 respectively. Conclusion: ABI is a simple and inexpensive screening tool in normal population. It can identify the severity of atherosclerosis in high risk asymptomatic and symptomatic subjects. ABI levels are lower in symptomatic group as compared to control and high risk asymptomatic groups, highlighting the long standing effect of cardiovascular risk factors on the extent of atherosclerosis