Ankle Brachial Index Intensifies the Diagnostic Accuracy of Epicardial Fat Thickness for the Prediction of Coronary Artery Disease Complexity

• Published in: Heart, lung & circulation Vol. 23; no. 8; pp. 764 - 771
• Main Authors: Aykan, Ahmet Çağrı, MD, Gül, İlker, MD, Gökdeniz, Tayyar, MD, Hatem, Engin, MD, Arslan, Ahmet Oğuz, MD, Kalaycıoğlu, Ezgi, MD, Turan, Turhan, MD, Belen, Erdal, MD, Çetin, Mustafa, MD
• Format: Journal Article
• Language: English
• Published: Australia Elsevier B.V 01.08.2014
• Subjects: Adipose Tissue - diagnostic imaging; Adipose Tissue - pathology; Aged; Angiography; Ankle Brachial Index; Cardiovascular; Coronary; Coronary Angiography; Coronary Artery Disease - diagnosis; Epicardial fat thickness; Female; Humans; Male; Middle Aged; Pericardium - diagnostic imaging; Pericardium - pathology; Peripheral artery disease; Prospective Studies; Severity of Illness Index; SYNTAX; Peripheral artery disease; Coronary; Angiography; Ankle brachial index; Epicardial fat thickness; SYNTAX
• ISSN: 1443-9506; 1444-2892
• DOI: 10.1016/j.hlc.2014.03.007

Objectives Epicardial fat thickness (EFT) and Ankle brachial index (ABI) are associated with coronary artery disease (CAD). The SYNTAX score (SS) reflects the complexity of CAD. We aimed to evaluate the relation of EFT and ABI with CAD complexity. Methods We enrolled 197 patients undergoing coronary angiography. In all patients, ABI and EFT were determined. SS was calculated. The relationship between EFT, ABI and SS was analysed. Results ABI and EFT were significantly correlated with SS (r = -0.525, p < 0.001, and r = 0.650, p < 0.001, respectively) and found to be independent predictors of SS. ABI<0.9 mm identified patients with SS>22 with a sensitivity of 45.28% and a specificity of %82.64 (AUC = 0.689, %95 CI = 0.619-0.763, p<0.001). The optimal cutoff value for EFT was 5 mm, yielding a sensitivity of 81.1% and a specificity of 90.3% (AUC = 0.859, 95% CI 0.802–0.904). In order to identify which parameters were the most accurate, we compared both AUC of ROC curves and there was no difference (p = 0.170). Conclusion EFT and ABI enables the noninvasive prediction of CAD severity in patients with suspected CAD and combining ABI to EFT was additive for the prediction of coronary artery disease complexity.