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Non-invasive test for atherosclerosis

ATHENS, GREECE. The ratio of the systolic blood pressure measured at the ankle and in the arm (brachial pressure) is used as an indication of the presence of peripheral arterial diseases such as intermittent claudication. Researchers at the Alexandra University Hospital now report that the ankle-brachial pressure index (ABI) can also be used to determine the extent of coronary atherosclerosis. The study included 165 patients (41 women and 124 men between the ages of 50 and 70 years) scheduled for elective coronary angiography.

The study participants underwent ultrasound imaging as well as angiography and also had a fasting blood sample drawn. In addition, all participants had their blood pressure measured in the supine position (after five minutes of rest) at the ankle and in the arm. The researchers found a significant correlation between ABI and smoking and diabetes. Body mass index, hypertension, cholesterol, triglycerides, HDL and LDL cholesterol, uric acid, fibrinogen, and insulin level were not significantly related to ABI. ABI was inversely related to the extent of narrowing of coronary arteries (at the carotid bifurcation - a strong marker of coronary artery disease). A low ABI (less than 0.9) was also found to correlate well with an increased severity of arterial blockage. The study participants were followed for 14 months during which time six died from cardiovascular causes, five experienced a non-fatal heart attack, 15 were hospitalized with unstable angina, 30 underwent bypass surgery, and 29 underwent angioplasty. The researchers noted that the rate of adverse events among the patients with an ABI less than 0.9 was 27 per cent as compared to only 10 per cent among the patients with an ABI greater than 0.9. The researchers conclude that a low ABI is an indicator of atherosclerosis and a risk factor for cardiovascular events.
Papamichael, Christos M., et al. Ankle-brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease. American Journal of Cardiology, Vol. 86, September 15, 2000, pp. 615-18

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