Role of Ankle Brachial Pressure Index (ABI) in Screening Patients with Risk Factors For Developing Peripheral Vascular Disease

Abstract

Background: Peripheral vascular diseases (PVDs) are trigged by various risk factors. The presence of PVD is associated with higher cardiovascular morbidity and mortality. Ankle brachial index (ABI) is the sensitive and also cost-effective diagnosing tool for peripheral artery disease. ABI is important for screening of peripheral arterial disease in patients at risk and for diagnosing the disease in patients having lower-extremity symptoms. Materials and Methods: This prospective observational study was performed at J. N. Medical College, A. M. U., Aligarh, UP on 135 adult patients who are asymptomatic for PVD but have one or more risk factors. Demographic and clinical data were recorded. Systolic Blood pressure of both arms and lower limb were measured using sphygmomanometer and hand held Doppler. Ankle brachial pressure index (ABPI) is detected by dividing higher of the two ankle pressures by the higher of the two brachial artery pressure. Results: Majority of the patients were aged between 46 and 65 years, males more than females. It was observed that diabetes, hypertension, smoking, and dyslipidemia patients have significantly lower ABPI score (<0.9) compared to other patients. USG Doppler has showed 10.4% were having abnormal findings and the ABI (0.68 ± 0.17) was significantly lower than the normal ones (0.89 ± 0.09). Receiver operating curve shows that ABPI below 0.77 can be used as cut-off to predict the occurrence and risk of developing PVD for screening asymptomatic with sensitivity 88.4 and specificity 85.7 and accuracy 90.1%. Conclusion: Comorbid conditions such as smoking, diabetes, hypertension, and dyslipidemia increase the risk of PVD. ABPI is a valid method to screen PVD with high levels of sensitivity and specificity.