Ankle–Brachial Index, plasma homocysteine, and brachial-ankle pulse wave velocity are important indicators in the diagnosis of early stage lower-extremity arterial occlusive disease

Background: This study evaluated noninvasive methods for the diagnosis and classification of lower-extremity arterial occlusive disease (LEAOD), specifically, plasma homocysteine (pHcy), ankle–brachial index (ABI), and brachial-ankle pulse wave velocity (baPWV). Materials and Methods: The study involved 102 patients with intermittent claudication treated at Beijing Chao Yang Hospital from 2010 to 2011. The affected arteries were assessed by computed tomography angiography (CTA) and categorized depending on the degree of occlusion as normal, stenotic, or occluded. ABI, pHcy, and baPWV were measured and compared among the groups. Factors that can affect ABI readings were analyzed. Results: Compared with patients in the normal group, the stenotic and occluded patients had significantly higher pHcy and baPWV, and lower ABI levels. The pHcy levels of the stenotic and occluded groups were similar. While statistically significant different ABI and baPWV levels were shown between the stenotic and occluded groups. The t values were 9.43 and 3.76, and the P < 0.001 and 0.001, respectively. Hypertension, diabetes mellitus, and blood cholesterol, C-reaction protein, and pHcy levels can influence the ABI value. Conclusion: ABI, pHcy, and baPWV values correlated with the results of the CTA examination with regard to LEAOD classification. ABI and baPWV may be useful for the categorical diagnosis of the disease. These findings contribute to the early diagnosis of LEAOD using noninvasive methods.