Key result
In asymptomatic women with diabetes, an ankle-brachial pressure index <0.9 was associated with a significantly greater ischemic total perfusion deficit compared to an index ≥0.9 (12.1% vs. 5.1%, P=0.04).
Why the study?
Does the ankle-brachial pressure index (ABI) identify significant ischemic total perfusion deficit in asymptomatic women with diabetes and suspected CAD?
Observational (n=407)
No
Does the ankle-brachial pressure index (ABI) identify significant ischemic total perfusion deficit in asymptomatic women with diabetes and suspected CAD?
Absolute Event Rate: 12.1% vs 5.1%
p-value: p=0.04
An ABI < 0.9 is a useful non-invasive marker to identify asymptomatic diabetic women at high risk for significant coronary ischemia.
May flag higher ischemia risk in asymptomatic diabetic women; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Clinical symptoms of coronary artery disease (CAD) are often atypical in women, particularly in those with diabetes mellitus. Therefore, a simple diagnostic test to identify a high-risk subset of women with diabetes who are likely to have CAD is important. METHODS AND RESULTS: A total of 407 consecutive patients (319 men and 88 women, age range 68 ± 11 years) with suspected CAD, who were not complaining of anginal pain, were evaluated. Among these patients, 170 had diabetes. Stress myocardial perfusion imaging and simultaneous brachial and ankle blood pressure measurements were performed to obtain the ischemic total perfusion deficit (TPD) and ankle-brachial pressure index (ABI), respectively. Ischemic TPD was not significantly different between men and women, whereas ischemic TPD was significantly greater in diabetic patients than in non-diabetic patients (6.9 ± 7.7% vs. 4.9 ± 6.1%; P = 0.005). In diabetic patients, ischemic TPD was not significantly different between men and women. However, women with ABI<0.9 showed significantly greater ischemic TPD than those with ABI≥0.9 (12.1 ± 10.8% vs. 5.1 ± 5.9%; P=0.04), whereas no difference in ABI was observed in men. CONCLUSIONS: ABI was useful in evaluating CAD in asymptomatic women with diabetes to detect a high-risk subset showing the ischemic TPD of >10%, which is regarded as a scintigraphic indicator for coronary revascularization.
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Igarashi et al. (2011) conducted an observational in Suspected coronary artery disease without anginal pain (n=407). Ankle-brachial pressure index (ABI) <0.9 vs. Ankle-brachial pressure index (ABI) ≥0.9 was evaluated on Ischemic total perfusion deficit (TPD) in women with diabetes (p=0.04). In asymptomatic women with diabetes, an ankle-brachial pressure index <0.9 was associated with a significantly greater ischemic total perfusion deficit compared to an index ≥0.9 (12.1% vs. 5.1%, P=0.04).
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