Usefulness of the Ankle-Brachial Index to Predict High Coronary SYNTAX Scores, Myocardium at Risk, and Incomplete Coronary Revascularization

Sebastianski, Meghan; Narasimhan, Seshasayee; Graham, Michelle M.; Toleva, Olga; Shavadia, Jay; Abualnaja, Seraj; Tsuyuki, Ross T.; McMurtry, M. Sean

doi:10.1016/j.amjcard.2014.09.010

Cited by 22 publications

(19 citation statements)

References 22 publications

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“…These results indicate that the value of ABI is a simple non-invasive clinical test that predicts the severity of CAD, help in decision making regarding patient selection for coronary angiography and can be combined with SS1 to predict the outcome of percutaneous coronary intervention as suggested in SHINANO Registry [11] in Japan. Our results are in agreement with the results of to Sebastianski et al [12], in a study of 814 patients, 8% had PAD (ABI <0.90), which concluded that patients with PAD were more likely to have high SYNTAX scores (>33), with an odds ratio of 4.3 (95% confidence interval 1.2 to 14.9), compared with those with normal ABIs after adjustment for traditional cardiovascular risk factors. Also, several studies had demonstrated that ABI correlates with the presence and severity of coronary atherosclerosis [6,[13][14][15][16][17][18][19].…”

Section: Discussionsupporting

confidence: 93%

The Value of Ankle Brachial Index in Predicting the Severity of Coronary Artery Disease

Mahfouz¹,

El‐Demerdash²,

Altantawy³

et al. 2018

Cardiol Vasc Res

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Section: Discussionsupporting

confidence: 93%

The Value of Ankle Brachial Index in Predicting the Severity of Coronary Artery Disease

Mahfouz¹,

El‐Demerdash²,

Altantawy³

et al. 2018

Cardiol Vasc Res

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“…Since coronary artery disease and peripheral arterial disease are manifestation of atherosclerotic process, it is considered that ankle-brachial index may also reflect coronary atherosclerotic burden [7]. Few studies have also shown a link between ankle-brachial index and Syntax score, a lesion based angiographic scoring system introduced as a tool to grade the complexity of coronary lesions [7] [8]. However, there are no such studies from India till date.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Ankle-Brachial Index, Waist-Hip Ratio, Ejection-Fraction, Obesity, Smoking, Alcohol Habits, Diabetes and Hypertension as Independent Predictors of Complexity and Severity of Coronary Artery Disease

Cheruku¹,

Otikunta²,

Reddy³

et al. 2015

IJCM

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Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and complexity of coronary artery disease. Methods: Patients diagnosed with coronary artery disease at our hospital between September-2012 and December-2014 were examined in this study. Selected patients were screened for cardiovascular risk factors including diabetes, hypertension, smoking, and alcohol habits as well as for clinical parameters including body-mass index, waist-hip ratio, ankle-brachial index, and ejection fraction. All patients underwent coronary angiography and were evaluated for severity of coronary artery disease (based on number of vessels involved) and complexity of coronary angiographic lesions (measured by computer-assisted Syntax score calculator). The collected data were analyzed to determine the role of cardiovascular risk factors and clinical parameters as predictors of complexity and severity of coronary artery disease. Results: A total of 211 patients (mean age: 54.64 ± 9.9 years; 81% males) with coronary artery disease were analyzed. Findings revealed that diabetes mellitus (p < 0.001), hypertension (p < 0.001), smoking habits (p = 0.036), and low ankle-brachial index (p < 0.001) were independent predictors of complex coronary artery disease as measured by Syntax score. Significant associations were also evident between severity of coronary artery disease and diabetes mellitus (p < 0.001), hypertension (p < 0.001), and ankle-brachial index (p < 0.001). Conversely, other cardiovascular risk factors including body-mass index, alcohol habits, wait-hip ratio, and ejection fraction did not exhibit significant associations with severity and complexity of coronary artery. Conclusions: The early diagnosis of coronary artery can be predicated by evaluating diabetes, hypertension, and smoking habits in patients presenting with acute coronary syndrome. In addition, ankle-brachial index can be used as an effective non-invasive bedside tool, as an al-N. K. Cheruku et al. 839 ternative to Syntax score, in predicting the severity and complexity of coronary artery disease.

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“…A high SYNTAX score was also an independent predictor of MACE after multivariate analysis. Although the mechanism of the association between the SYNTAX score and MACE might be multifactorial, previous reports demonstrated that a higher SYNTAX score was associated with complex CAD and a higher prevalence of diabetes mellitus and peripheral artery disease, suggesting that the SYNTAX score may be related to advanced coronary and systemic atherosclerosis [24, 25]. …”

Section: Discussionmentioning

confidence: 99%

Prediction of 1-year clinical outcomes using the SYNTAX score in patients with prior heart failure undergoing percutaneous coronary intervention: sub-analysis of the SHINANO registry

et al. 2016

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Although coronary artery disease (CAD) is common in patients with heart failure (HF), little is known about the prognostic significance of coronary lesion complexity in patients with prior HF undergoing percutaneous coronary intervention (PCI). The aim of this study was to investigate whether the coronary Synergy between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery (SYNTAX) score could improve risk stratification in HF patients with CAD. Two hundred patients (mean age 73 ± 11 years, left ventricular ejection fraction 49 ± 15 %) with prior HF who underwent PCI were divided into two groups stratified by SYNTAX score (median value 12) and tracked prospectively for 1 year. The study endpoint was the composite of major adverse cardiovascular events (MACE), including all-cause death, myocardial infarction, stroke, and hospitalization for worsening HF. Adverse events were observed in 39 patients (19.5 %). Patients with high SYNTAX scores (n = 100) showed worse prognoses than those with low scores (n = 100) (26.0 vs. 13.0 %, respectively, P = 0.021). In multivariate Cox-regression analysis, SYNTAX score ≥12 was significantly associated with MACE (hazard ratio: 1.99, 95 % confidence interval: 1.02–3.97; P = 0.045). In patients with prior HF and CAD, high SYNTAX scores predicted a high incidence of MACE. These results suggest that the SYNTAX score might be a useful parameter for improving risk stratification in these patients.

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Usefulness of the Ankle-Brachial Index to Predict High Coronary SYNTAX Scores, Myocardium at Risk, and Incomplete Coronary Revascularization

Cited by 22 publications

References 22 publications

The Value of Ankle Brachial Index in Predicting the Severity of Coronary Artery Disease

The Value of Ankle Brachial Index in Predicting the Severity of Coronary Artery Disease

Analysis of Ankle-Brachial Index, Waist-Hip Ratio, Ejection-Fraction, Obesity, Smoking, Alcohol Habits, Diabetes and Hypertension as Independent Predictors of Complexity and Severity of Coronary Artery Disease

Prediction of 1-year clinical outcomes using the SYNTAX score in patients with prior heart failure undergoing percutaneous coronary intervention: sub-analysis of the SHINANO registry

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