Key result
ABPI correlates with global atheroma burden in symptomatic PAD while CIMT shows no association.
Why the study?
Do CIMT and ABPI correlate with global atheroma burden measured by WB-MRA in patients with symptomatic peripheral arterial disease?
Cross-Sectional (n=50)
Blinded assessors
No
Do CIMT and ABPI correlate with global atheroma burden measured by WB-MRA in patients with symptomatic peripheral arterial disease?
Effect estimate: β -0.45
p-value: p=0.005
In patients with symptomatic peripheral arterial disease, ABPI, but not CIMT, correlates with global atheroma burden, though this is primarily driven by local ilio-femoral disease.
ABPI may better reflect global atherosclerosis extent than CIMT in symptomatic PAD; leaves open its added prognostic value in prospective studies.
BACKGROUND: Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA). METHODS: 50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR). The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50-70%, 3 = 70-99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated. RESULTS: The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045), however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01) with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β -0.39, p = 0.012), which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45), while the correlation between ABPI and atheroma burden persisted (β -0.45 p = 0.005). CONCLUSION: ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral arterial disease. However this is primarily due to a strong correlation with ilio-femoral atheroma burden.
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Weir‐McCall et al. (2014) conducted a cross-sectional in Symptomatic peripheral arterial disease (n=50). Ankle-Brachial Pressure Index (ABPI) and Common Carotid Intima Media Thickness (CIMT) was evaluated on Correlation with global atheroma burden (standardised atheroma score) measured by whole body magnetic resonance angiography (β -0.45, p=0.005). Ankle-Brachial Pressure Index significantly correlated with global atheroma burden (β -0.45, p=0.005), whereas Common Carotid Intima Media Thickness did not (β 0.13, p=0.45) in patients with symptomatic peripheral arterial disease.
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