Diagnostic accuracy of ankle-brachial index measurement in peripheral Arterial disease in TurkishAdults: A comparison with angiography

Medical Science and Discovery Pub Date : 2023-12-16 DOI:10.36472/msd.v10i12.1074

Tolga Doğan, İlker Taşçı, U. Bozlar, Birol Yıldız, Cengizhan Açıkel, S. Sayın, Celalettin Günay, Erol Arslan, Kenan Sağlam

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Abstract

Objective: This study aims to assess the sensitivity and specificity of ankle-brachial index (ABI) measurements in diagnosing peripheral artery disease (PAD) among a cohort of Turkish subjects, with angiography serving as the reference standard. Material and Methods: In this single-center, cross-sectional and observational study, subjects who had an aorta and lower extremity arterial imaging by angiography subsequently underwent an ABI measurement. Anthropometric measurements, cardiovascular risk factors, and blood biochemistry data were recorded. Sensitivity and specificity analyses were performed for a low ankle-brachial index (ABI ≤ 0.9), with angiography as the reference standard. Results: A total of 57 patients (age: 59.1±15.9, male/female: 47/10) were included. Diabetes mellitus, coronary artery disease and cerebrovascular disease were present in 40.4%, 42.1% and 15.8% of the participants, respectively. Three or more cardiovascular risk factors were present in 54.4%. The angiographic diagnostic method was computed tomography angiography in 57.9%, digital subtraction angiography in 38.6%, and magnetic resonance angiography in 3.5% of the subjects. The presence of PAD on angiography was documented in 55 of 57 participants. The calculated mean ABI value was 0.6±0.2 in the overall group, and a low ABI (≤0.9) was found by 82.5% (n = 47). Compared to angiography, the low ankle-brachial index (ABI) test demonstrated a sensitivity of 83.6% and a specificity of 50%. The positive predictive value of 97.9% was calculated. When an ABI≤0.95 was used as the diagnostic threshold, the sensitivity of the ABI test increased to 90.9%. Conclusion: Our study confirms the reliability of ABI measurements as a diagnostic method for lower extremity peripheral artery disease (PAD) when compared to angiographic techniques, the gold standard. Establishing a higher cut-off value (≤0.95) may enhance the diagnostic performance of the test in Turkish patients.

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踝肱指数测量对土耳其成年人外周动脉疾病的诊断准确性：与血管造影术的比较

研究目的本研究旨在评估踝肱指数（ABI）测量值在诊断土耳其受试者外周动脉疾病（PAD）方面的敏感性和特异性，并以血管造影术作为参考标准：在这项单中心、横断面和观察性研究中，通过血管造影术进行主动脉和下肢动脉成像的受试者随后接受了 ABI 测量。研究人员还记录了人体测量数据、心血管风险因素和血液生化数据。以血管造影为参考标准，对低踝肱指数（ABI ≤ 0.9）进行敏感性和特异性分析：共纳入 57 名患者（年龄：59.1±15.9，男女比例：47/10）。40.4%、42.1%和15.8%的患者患有糖尿病、冠心病和脑血管疾病。54.4%的人存在三种或三种以上的心血管风险因素。血管造影诊断方法为：57.9%的受试者采用计算机断层扫描血管造影，38.6%的受试者采用数字减影血管造影，3.5%的受试者采用磁共振血管造影。在 57 名受试者中，有 55 人在血管造影检查中被证实患有 PAD。计算得出的全组平均 ABI 值为 0.6±0.2，82.5% 的受试者（n = 47）发现 ABI 值偏低（≤0.9）。与血管造影相比，低踝肱指数（ABI）检测的敏感性为 83.6%，特异性为 50%。计算得出的阳性预测值为 97.9%。当以 ABI≤0.95 作为诊断阈值时，ABI 检测的灵敏度上升至 90.9%：我们的研究证实，与血管造影技术（金标准）相比，ABI 测量作为下肢外周动脉疾病（PAD）诊断方法的可靠性。确定一个较高的临界值（≤0.95）可提高该测试在土耳其患者中的诊断性能。

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Medical Science and Discovery

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