Agreement Between ABI (Ankle Brachial Index) and USD (Ultrasound Duplex Scanning) in Symptomatic Peripheral Arterial Disease Patients

Abstract

Background: Atherosclerosis of the peripheral arteries occurs in 12% of individuals at 65 years of age or older. At least 28% of these patients suffer from coronary heart diseases and 10% of them are afflicted with cerebrovascular diseases. To calculate the agreement between two diagnostic tests for peripheral arterial disease (PAD), namely ankle brachial index (ABI) and ultrasound duplex scanning (USD).

Methods: Forty symptomatic PAD patients were enrolled in this study, and their demographic characteristics, risk factors, and symptoms as well as their ABI and USD measurements were recorded. On the basis of the symptoms and ABI and USD findings, the patients were divided into four groups and comparisons were made between them so that the associations between the findings could be analyzed.

Results: The study population included 32 (80%) men at a mean age of 62.9+12.8 years (26-90). Smoking (75%) and hypertension (100%) were the most common risk factors in the men and women, respectively, followed by diabetes in both genders. Whereas the agreement between ABI and USD findings in the men was significant (Kappa=0.28, P=0.02), it was not significant (Kappa=-0.91, P=0.68) in the women. Additionally, there was a significant correlation between symptoms and ABI findings (Kappa=0.21, P=0.04), while that between symptoms and USD measurements was not significant (Kappa=0.09, P=0.3)

Conclusion: The correlation between ABI findings and symptoms, especially in the men, was better than that between ABI findings and USD measurements. ABI could, therefore, be considered an appropriate tool for the initial screening of arterial stenosis and lower extremity circulation.