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VOLUME 4 , ISSUE 2 ( July-December, 2020 ) > List of Articles


Angiographic Assessment of Coronary Artery Disease and its Correlation with Ankle-brachial Index in Patients with Diabetes Mellitus

Gaurav Mohan, Baldeep Singh, Vishavveer Kaur

Citation Information : Mohan G, Singh B, Kaur V. Angiographic Assessment of Coronary Artery Disease and its Correlation with Ankle-brachial Index in Patients with Diabetes Mellitus. Curr Trends Diagn Treat 2020; 4 (2):69-73.

DOI: 10.5005/jp-journals-10055-0108

License: CC BY-NC 4.0

Published Online: 01-04-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Background: Coronary artery disease (CAD) due to atherosclerosis is like an epidemic in India. The role of diabetes mellitus (DM) with CAD is believed to be as important as CAD itself. Owing to the similar vascular involvement, patients with DM were frequently combined with peripheral artery disease (PAD). Although in outpatients, clinically suspected of having CAD, the relationship and interaction between DM and PAD remain unknown. Aim and objective: The aim and objective of this study is to evaluate the relation of the ankle-brachial index (ABI) with the angiographic characteristics of CAD in patients with DM. Materials and methods: This is a tertiary hospital study in which 50 adult patients were admitted and taken according to inclusion and exclusion criteria for the study. All patients in this study population underwent ABI measurement and coronary angiography was done. Patients were subdivided into two groups according to ABI, that is, patients with ABI >0.90 and ABI <0.90. Results: There was a significant relationship between low ABI and severity of CAD. Low ABI group patients had a more severe form of CAD with a higher prevalence of triple vessel diseases, severe stenosis, and more involvement of the left anterior descending (LAD)artery. Risk factors like hypertension, diabetes mellitus, and low ABI were predictors of significant severe stenosis of coronary arteries. Conclusion: Low ABI is a surrogate index of the severity of CAD. So it could be used in our everyday clinical cardiology practice as a noninvasive, easy, and cheap bedside test to assess and predict the severity of CAD.

  1. E. Luebering, Kara Rogers, Marco Sampaolo, Grace Young. December 2017. “Diabetes Mellitus-Medical Disorder”. Encyclopaedia Britannica.
  2. Diabetes Fact sheet N°312; October 2013.
  3. Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Phys Ther 2008;88(11):1322–1335. DOI: 10.2522/ptj.20080008.
  4. Macrovascular complications in patients with diabetes and prediabetes. Biomed Res Int 2017;2017:7839101. DOI: 10.1155/2017/7839101.
  5. Atherosclerotic burden in coronary and peripheral arteries in patients with first clinical manifestation of coronary artery disease. Heart Vessels 2002;16(6):217–226. DOI: 10.1007/s003800200028.
  6. Relationship of high and low ankle brachial index to all-cause and cardiovascular disease mortality: the Strong Heart Study. Circulation 2004;109(6):733–739. DOI: 10.1161/01.CIR.0000112642.63927.54.
  7. Ankle systolic pressure measurements in arterial diseases affecting the lower extremities. Br J Surg 1969;56(9):676–679. DOI: 10.1002/bjs.1800560910.
  8. Ankle-brachial index and subclinical cardiac and carotid disease: the multi-ethnic study of atherosclerosis. Am J Epidemiol 2005;162(1):33–41. DOI: 10.1093/aje/kwi167.
  9. Association between ankle-brachial index and coronary lesions assessed by coronary angiography cardiology research. Cardiol Res 2015;6(1):216–220. DOI: 10.14740/cr376w.
  10. Impact of diabetes and hypertension on cardiovascular outcomes in patients with coronary artery disease receiving percutaneous coronary intervention. BMC Cardiovasc Disord 2017;17(1):12. DOI:10.1186/s12872-016-0454-5.
  11. Angiographic severity and morphological spectrum of coronary artery disease in non insulin dependent diabetes mellitus. Indian Heart J 1995;47(4):343–348.
  12. Quantitative comparison of angiographic characteristics of coronary artery disease in patients with noninsulin dependent diabetes mellitus compared with matched nondiabetic control subjects. Am J Cardiol 1997;80(5):550–556. DOI: 10.1016/s0002-9149(97)00420-7.
  13. Association of glycosylated haemoglobin level and diabetes mellitus duration with the severity of coronary artery disease. Diab Vasc Dis Res 2008;5(3):184–189. DOI: 10.3132/dvdr.2008.030.
  14. Association of classical risk factors and coronary artery disease in type 2 diabetic patients submitted to coronary angiography. Diabetol Metab Syndr 2014;6(1):46. DOI: 10.1186/1758-5996-6-46.
  15. Duration and treatment of diabetes: relationship to severity of coronary artery disease. N Y State J Med 1979;79(11):1683–1688.
  16. The prevalence of diabetics and non-diabetic subjects in an English community. Diab Medicine 1992;9:710–715.
  17. Peripheral vascular disease in diabetes mellitus and its relation to cardiovascular risk factors screening with Doppler. Diabetes Care 1980;3(2):207–213. DOI: 10.2337/diacare.3.2.207.
  18. Ankle-arm index as a predictor of lesion morphology and risk classification for coronary artery disease undergoing angioplasty. Int J Cardiol 2006;113(3):385–390. DOI: 10.1016/j.ijcard.2005.11.102.
  19. Ankle-brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease. Am J Cardiol 2000;86(6):615–618. DOI: 10.1016/s0002-9149(00)01038-9.
  20. Usefulness of an abnormal ankle-brachial index to predict presence of coronary artery disease in African-Americans. Am J Cardiol 2004;93(4):481–483. DOI: 10.1016/j.amjcard.2003.10.050.
  21. Ankle-brachial index as a prognostic factor and screening tool in coronary artery disease: does it work?. J Tehran Heart Cent 2014;9(4):174–178.
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