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Journal of Clinical Cardiology

ISSN: 2694-5088

Original Research Open Access
Volume 6 | Issue 1 | DOI: https://doi.org/10.33696/cardiology.6.067

The Diagnostic Accuracy of Ankle Brachial Index in Relation to Coronary Computed Tomography in Coronary Artery Disease

Shereen Mostafa Ahmed1, Ossama Sanad Arafa1, Mohamed Abdelmoaty Emam Nasr1,*, Mohamed Abdelshafy Tabl1
  • 1Department of Cardiology, Faculty of Medicine, Banha University, Banha, Egypt
+ Affiliations - Affiliations

Corresponding Author

Mohamed Abdelmoaty Emam Nasr, rebasant9@gmail.com

Received Date: November 24, 2024

Accepted Date: January 23, 2025

Citation:

Ahmed SM, Arafa OS, Nasr MAE, Tabl MA. The Diagnostic Accuracy of Ankle Brachial Index in Relation to Coronary Computed Tomography in Coronary Artery Disease. J Clin Cardiol. 2025;6(1):23-32.


Copyright: © 2025 Bowden RG, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Arterial stiffness and loss of recoil indicate arterial aging and increase cardiovascular risk, particularly for ischemic heart disease. Advances in coronary computed tomography angiography (CCTA) enhance the detection of coronary artery disease (CAD) through high-quality imaging and plaque analysis. This study's objective is evaluating the ankle-brachial index (ABI) accuracy in diagnosing CAD compared to CCTA.

Methods: A prospective, observational study was executed with 200 participants who underwent ABI measurement and CCTA, with CAD severity assessed via the Gensini score. In accordance with Gensini scores, the patients were split into two distinct groups, Group 1: low Gensini score and Group 2: high Gensini score.

Results: The mean ABI was 96.26 ± 9.3%, with 29% of patients showing abnormal readings. Patients with abnormal ABI were significantly older and exhibited a higher prevalence of hypertension (60.5%), diabetes (43%), and dyslipidemia (52%). The ABI effectively distinguished between normal and abnormal readings, achieving an AUC of 0.866 at a cutoff of ≤ 98%, with 100% sensitivity and 55.63% specificity. Coronary artery calcium (CAC) scores showed superior diagnostic performance with an AUC of 0.920 at a cutoff of >169, yielding 91.38% sensitivity and 84.29% specificity. The Gensini score demonstrated an AUC of 0.723 at a cutoff of >94, providing 70.69% sensitivity and 76.60% specificity.

Conclusion: CAC and Gensini scores were significantly elevated in the abnormal ABI group highlighting a clear correlation between lower ABI values and greater CAD severity. CAC scores showed excellent diagnostic accuracy, while ABI had high sensitivity but lower specificity for CAD assessment. The Gensini score is used as invasive method to assess severity of CAD correlated to Calcium scoring and ABI. Overall, the findings support using both ABI and CAC scoring in evaluating CAD, especially in at-risk groups.

Keywords

Ankle-brachial index, Coronary artery disease, Coronary computed tomography angiography, Coronary artery calcium, Gensini score, Ischemic heart disease, Arterial stiffness

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