Relationship Among Ankle Brachial Index, Carotid Intima-media Thickness And Conventional Risk Factors In Coronary Artery Disease

Objective:To investigate the relationship between Ankle Brachial Index(ABI) and Carotid Intima-media Thickness(IMT)and it's diagnostic value on coronary artery disease.To assess the impact of ABI,IMT and conventional cardiovascular risk factors on coronary arteriosclerosis.Methods:From 2005 to 2006,162 inpatients were performed coronary angiography,ABI,and IMT.The cardiovascular risk factors including age, gender,smoking,hypertension,family history,body mass index(BMI),total cholesteral(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),blood glucose were investigated.The number of coronary atherosis vessels and Gensini's coronary angiography score were calculated to quantify the extent of coronary artery atherosclerosis.The correlation between ABI and IMT in different atherosis degree was analysised.ABI and IMT were used to predict coronary artery disease and compare the diagnostic value.The relationship among ABI,IMT,risk factors and extent of coronary artery atherosclerosis were studied by multiple linear regression.Results:(1)ABI among normal coronary angiography group,single vessel disease group and multi-vessel disease group had statistical signification(P＜0.001).The severer extent of coronary artery atherosclerosis is, the lower ABI it is.IMT among normal coronary angiography group,single vessel disease group and multi-vessel disease group had statistical signification(P＜0.001).The severer extent of coronary artery atherosclerosis is, the thicker IMT is.(2)Using Gensini's coronary angiography score as concomitant variable to calculate the coefficient of partial correlation,ABI and IMT showed negative correlation(r=-0.261,p=0.001).Using the number of sclerotic vessel as concomitant variable to calculate the coefficient of partial correlation,ABI and IMT showed negative correlation(r=-0.232,p=0.003). Using the number of sclerotic vessel as grouping variable to analysis the correlation,ABI and IMT showed negative correlation only when coronary atherosclerosis existed.(3)Drawing the receiver operating characteristic curve(ROC)of ABI and IMT respectively for predicting coronary artery disease, the results showed when ABI is 1.035 as critical point for predicting coronary artery disease,the sensitivity is 84.5%,and the specificity is 90.4%;when IMT is 0.93 as critical point for predicting coronary artery disease,the sensitivity is 79.1%,and the specificity is 75.0%.(4)Multiple linear regression analysis showed that ABI,BMI,smoking,IMT,diabetes,LDL,and family history were all associated with Gensini coronary angiography score significantly.Conclusions:ABI and IMT are both significantly correlated with the extent of coronary artery atherosclerosis and can predict coronary artery disease.ABI is significantly negative correlated with IMT in coronary artery disease.ABI,BMI, smoking,IMT,diabetes,LDL,and family history were all associated with the extent of coronary artery therosclerosis.Using ABI and IMT to screen coronary artery disease and assess the extent of coronary artery atherosclerosis is significant in high risk patients...