Key result
An ABI/CIMT ratio ≤1.55 showed better predictive value for CAD and stronger correlation with CAD severity than either marker alone.
Why the study?
Whether the ratio of ankle-brachial index to carotid intima-media thickness provides added value in predicting CAD compared with either marker alone had not been studied.
Does the ABI/CIMT ratio have incremental value over CIMT or ABI alone in predicting the presence and severity of coronary artery disease in stable non-ACS patients?
Observational (n=235)
No
Does the ABI/CIMT ratio have incremental value over CIMT or ABI alone in predicting the presence and severity of coronary artery disease in stable non-ACS patients?
Answers are grounded in this paper and cite their sources.
The ABI/CIMT ratio provides incremental predictive value over either marker alone for detecting the presence and severity of coronary artery disease in stable patients.
Background: Studies have shown that carotid intima-media thickness (CIMT) and ankle–brachial pressure index (ABI) can be used as surrogate markers of coronary artery disease (CAD). However, whether studying the ratio of ABI and CIMT has any added value in predicting CAD when compared to either of them alone, has not been studied. Aims: The aim of the study is to compare CIMT and ABI as surrogate markers for the presence and extent of CAD and to investigate whether studying the ratio of ABI and CIMT has any incremental value in predicting CAD than either of them. Methods: We prospectively enrolled 235 stable, non-ACS patients who underwent CIMT and ABI measurements followed by diagnostic coronary angiography. Results: The mean age of the study population was 56.32 ± 10.14 years. CIMT was significantly higher in the CAD group compared to non-CAD group (0.91 ± 0.22 vs. 0.66 ± 0.15, P ≤ 0.0001). ABI was significantly lower in the CAD group compared to non-CAD group (1.07 ± 0.19 vs. 1.18 ± 0.14, P ≤ 0.0001). At an optimal cutoff value of ≥0.75 mm, CIMT showed better predictive values (sensitivity and specificity –72.3% and 79%, respectively) compared to ABI ≤0.9 (sensitivity and specificity – 21.53% and 96.19%, respectively). CIMT was the strongest independent predictor of CAD (P < 0.0001) followed by ABI (P = 0.006) by multiple regression. ABI/CIMT ratio of ≤1.55 had better predictive value (sensitivity and specificity –75.4% and 78.1%, respectively) and stronger correlation with CAD severity (R = 0.42), than either of them. Conclusion: CIMT is a better surrogate marker of CAD compared to ABI. Studying ABI/CIMT ratio has an incremental value in predicting CAD.
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Iqbal et al. (2019) conducted an observational in Coronary artery disease (n=235). ABI/CIMT ratio vs. CIMT and ABI alone was evaluated on Presence and severity of coronary artery disease. An ABI/CIMT ratio ≤1.55 showed better predictive value for CAD and stronger correlation with CAD severity than either marker alone.
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