Predictive Value Of Ankle Brachial Index In Patients With Acute Coronary Syndrome

Background Atherosclerosis is the main reason of people's death today. Acute coronary syndrome(ACS) is a series of cardiovascular emergencies based on the pathological findings ranging from the rupture of atheromatous plaques to acute thrombosis in coronary arteries, which poses great threats on the health of human being. It is urgent to develop a detection method with higher sensitivity and specificity to assess the severity and short-term prognosis of ACS in clinical practice. Foreign studies have shown that ankle brachial index(ABI) is a simple,effective and noninvasive method to diagnose peripheral arterial disease(PAD). Ankle brachial index( ABI) can predict the severity of coronary artery stenosis and closely related to cardiovascular events and death in the future. There is still not any articles that evaluate the predictive value of ankle brachial index in patients with acute coronary syndrome(ACS).Objective This study was designed to discuss the relationship between ankle brachial index and the prognosis of ACS.Methods The hospitalized patients of acute cornary syndrome were consecutive enrolled and divided into two groups according to the ankle brachial index results. The major adverse cardiac events(MACE) of these patients, including death, recurrent myocardial infarction, intractable angina,heart failure and target vessel revascularization(TVR) were assessed at the end of the 12th month after discharged from hospital. We then analyzed the association of the adverse events with abnormal ankle brachial index .Results 119 patients enrolled. Normal ankle brachial index was present in 75 patients, and low ankle brachial index occurred in 44 patients. The clinical characteristics of low ankle brachial index group compared with normal ankle brachial index group were: (1)older patients were frequent(70.23±9.86vs 61.91±10.30,p<0.001), (2)patients with diabetes were frequent(54.5% vs 22.7%, p<0.01),(3) patients with hyperlipmia were frequent (65.9%vs25.3%,p<0.001),(4)patients with 3-vessel disease were frequent (61.4% vs 29.3%,p<0.01),(5)low left ventral ejection factor were frequent(47.86±5.72 vs 55 .41±8.45,p< 0.001)。The major adverse cardiac events occurred was greater frequent among patients with low ankle brachial index compared with those with normal ankle brachial index (68.2% vs18.7%,p=0.000). Multivariate Logistic regression analysis showed that after adjusement of age,diabetes,the history of myocardial infarction,LVEF,the major adverse cardiac events occurred was greater frequent among patients with low ankle brachial index.(OR=9.429, 95%C.I.1.635～54.387, P<0.001).Conclusions Ankle brachial index is a noninvasive method to assess the the severity of coronary artery stenosis of ACS patients. The prognosis of ACS patients with low ankle brachial index was poor because of the occurrence of the major adverse cardiac events. Ankle brachial index was a valuable factor for predicting the prognosis of patients with acute coronary syndrome.