A Comparative Assessment Of The Severity Of Coronary Artery Disease In Patients With Low Ankle-Brachial Index And Normal Ankle-Brachial Index: An Angiography-Based Cross-Sectional Observational-Analytical Study (Cadlabi Study)

Objectives: The ankle-brachial index (ABI) is an efficient tool and an indicator of generalized atherosclerosis. Still, there is uncertainty regarding the severity of coronary artery disease (CAD) in patients having low ABI. The uniqueness of this study is that it is the first largest study done with the aim to determine the severity of CAD in the form of a number of involvements of coronary vessel in patients with low ABI. Materials and Methods: It is a hospital-based cross-sectional observational-analytical study. A total of 500 patients of suspected CAD were recruited. ABI was measured first and then all patients were sent for coronary angiography. Based on ABI values, patients were divided into two groups, i.e., Group A (patients with low ABI or ABI <= 0.9) and Group B (patients with normal ABI or ABI >0.9). Results: Twenty-three, i.e., 4.6% of patients had ABI <0.9. All patients having low ABI had CAD. In assessing CAD severity, it was reported that in Group A, triple-vessel disease (TVD) was present in 65.2% (P = 0.0001), double-vessel disease in 21.7% (P = 0.72), single-vessel disease in 8.6% (P = 0.06), and noncritical CAD in 4.3% (P = 0.9) as compared to Group B. In patients with Group A, 52.1% were smoker (P = 0.01), 69.5% have increased body mass index (P = 0.71), 43.4% have a history of hypertension (P = 0.73), and 60.8% were diabetic (P = 0.0005). Conclusion: CAD is widely prevalent almost in all patients with low ABI and more than half of these patients have TVD on angiographic assessment.