Risk factors for patients with diabetes who have abnormal toe-brachial index and normal ankle-brachial index

Hamasaki, Hidetaka; Hamasaki, Yasuteru

doi:10.1055/s-0043-122491

Cited by 1 publication

(1 citation statement)

References 26 publications

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“…This is also the most likely reason why previous studies focused on diabetic patients (e.g. [15][16][17][18][19]22) reported poor results of ABI as they either adhered to HAP calculation, or, in the case of Premalatha et al, used the mean of both ankle pressures.…”

Section: Discussionmentioning

confidence: 99%

Ankle-brachial index in diabetic patients – which upper cut-off value is to be used?

Homza¹,

Machaczka²,

Porzer³

et al. 2019

BLL

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OBJECTIVES: In diabetic patients, there is a discrepancy in guidelines for ankle-brachial index (ABI) screening for peripheral arterial disease (PAD). While diabetes organizations suggest the value of upper limit of normal ABI to be 1.3, cardiologists recommend 1.4. Also, guidelines recommend using the higher value of ankle pressure (HAP) but multiple recent studies propose the opposite (LAP). METHODS: In this prospective study, we performed ABI measurements in 62 diabetic patients. Results were calculated by comparing higher and lower values of ankle pressure to those of duplex ultrasound (stenosis ≥ 50 % was considered PAD). Special attention was paid to patients with high and non-measurable ABI. RESULTS: LAP ABI appears to be a preferable method for PAD screening in diabetics. The upper cutoff value of 1.4 yielded better results with sensitivity of 93 % and negative predictive value of 91 %. No limbs with ABI between 1.3 and 1.4 with signifi cant stenosis were found. However, using HAP for the upper cutoff captured additional PAD patients. PAD was abundant among patients with high or non-measurable ABI. CONCLUSIONS: LAP should be used for assessing low ABI (cut-off 0.9) while HAP for detecting the abnormally high ABI. The preferable high ABI cutoff is 1.4. Condition with abnormally high or non-measurable ABI should be considered as PAD (Tab. 3, Ref. 22).

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