Comparison of Ankle-Brachial Index in Patients With and Without Atrial Fibrillation

UNLABELLED: The aim of this study was to compare the ankle-brachial index between patients with atrial fibrillation (AF) and those without atrial fibrillation. MATERIAL AND METHODS: A total of 286 patients admitted to the Departments of Neurology or Cardiology, Kaunas Clinical Hospital, during 2008-2010 and referred for a consultation with an internist and/or a cardiologist were included in this study. All patients had at least one prevalent cardiovascular disorder and were screened for diagnosis of permanent AF based on medical records and electrocardiogram and evaluated for the ankle-brachial index (ABI). Peripheral artery disease (PAD) was defined as an ABI of <0.9 assessed by using a 5-MHz Doppler ultrasound device. RESULTS: The patients with permanent AF had a significantly lower ABI compared with the patients without AF (P<0.001). Binary regression analysis revealed that permanent AF was associated with PAD (OR, 2.5; 95% 1.5-4.2). The likelihood of having an ABI of <0.9 increased with each additional risk factor: AF (OR, 2.2; 95% CI, 1.3-3.8), stroke (OR, 2.3; 95% CI, 1.3-4.2), age of >69 years (OR, 2.4; 95% CI, 1.3-4.7), and myocardial infarction (OR, 2.4; 95% CI, 1.1-5.5). Nearly one-fourth (24.5%) of all patients with an ABI of <0.9 did not report any PAD-specific symptoms. CONCLUSIONS: The patients with cardiovascular disorders and permanent atrial fibrillation were found to have a significantly lower mean ankle-brachial index and higher prevalence of peripheral artery disease compared with cardiovascular patients without atrial fibrillation. The patients who were found to have a lower ankle-brachial index and permanent atrial fibrillation were older and often had several cardiovascular diseases (angina pectoris, stroke, myocardial infarction, or hypertension).