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Title: Association of Severity of Coronary Artery Disease With SYNTAX Score and Ankle Brachial Index
Authors: Asma Zafar Khawaja, Muhammad Khalil, Syed Khurram Shahzad, Amna Yousaf, Maida Anwar, Iftikhar Ahmed, Javeria Kamran, Naseem Azad
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2024
Volume: 74
Issue: Supplementary 1
Language: English
Keywords: Ankle Brachial IndexCoronary angiographyCoronary Artery DiseaseSYNTAX Score
Objective: To compare the Ankle Brachial Index and SYNTAX score in predicting Coronary Artery Disease severity and the variation of ABI with respect to SYNTAX score.
Study Design: Analytical Cross-sectional study.
Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi; from Jan-Jun 2023.
Methodology: Total 216 coronary angiographically confirmed cases of Coronary Artery Disease were consecutively enrolled in study and data was gathered prospectively on a pre-designed proforma containing patients’ demographic details, risk factors and study’s focal variables such as; Ankle Brachial Index, SYNTAX Score, coronary artery disease severity. Association of categorized data was found by Chi-square test and Fischer Exact test. Correlation analysis was done to find the relationship between Ankle Brachial Index and SYNTAX score with p<0.05 was taken as statistically significant.
Results: Out of 216 study participants, males were 180(83.3%) and females were 36(16.7%) having mean age 59.97±10.72 years. Majority of the patients had low SYNTAX score, 96(44.4%) and 95(43.9%) patients ranged in 0.91-1.0 ABI. A statistically significant and negative correlation between ABI and SYNTAX score (r=-0.879; p<0.001) and significant association of ABI and SYNTAX score with CAD severity (p<0.001) was found.
Conclusion: Although Ankle Brachial Index is an indicator of Peripheral Arterial Disease but it can also be used as an independent predictor and non-invasive and time saving indicator of complexity of Coronary Artery Disease prior to coronary angiography.
To compare the Ankle Brachial Index (ABI) and SYNTAX Score (SS) in predicting Coronary Artery Disease (CAD) severity and to assess the variation of ABI with respect to SYNTAX score.
An analytical cross-sectional study was conducted on 216 patients with angiographically confirmed Coronary Artery Disease. Data on demographic details, risk factors, ABI, SYNTAX Score, and CAD severity were collected prospectively. Statistical analysis included Chi-square test, Fischer Exact test, and correlation analysis (Pearson's and Spearman's) to determine the association between ABI and SYNTAX score with CAD severity. A p-value < 0.05 was considered statistically significant.
graph TD;
A["Enroll 216 CAD Patients"] --> B["Collect Data: Demographics, Risk Factors, ABI, SYNTAX Score, CAD Severity"];
B --> C["Perform Statistical Analysis"];
C --> D["Chi-square Test"];
C --> E["Fischer Exact Test"];
C --> F["Correlation Analysis Pearson's, Spearman's"];
D --> G["Assess Associations"];
E --> G;
F --> G;
G --> H["Report Findings"];
The study suggests that ABI, while an indicator of Peripheral Arterial Disease, can also serve as an independent, non-invasive, and time-saving predictor of Coronary Artery Disease complexity prior to angiography. The findings align with previous literature indicating a negative correlation between ABI and SYNTAX score, where a lower ABI is associated with a higher SYNTAX score and increased CAD risk.
A statistically significant and negative correlation was found between ABI and SYNTAX score (r=-0.879; p<0.001). There was also a significant association of ABI and SYNTAX score with CAD severity (p<0.001). The study observed a decreasing trend of SYNTAX score with an increasing trend of ABI.
Ankle Brachial Index can be utilized as an independent predictor and a non-invasive, time-saving indicator of Coronary Artery Disease complexity, even before coronary angiography. ABI scoring can be easily applied to determine CAD severity at the bedside for patients diagnosed with acute coronary syndrome.
1. Sample Size: The study enrolled 216 coronary angiographically confirmed cases of Coronary Artery Disease.
2. Correlation Coefficient: A statistically significant and negative correlation between ABI and SYNTAX score was reported as r=-0.879.
3. Study Duration: The study was conducted from January to June 2023.
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