Ankle‐brachial index and carotid ultrasound as surrogates for coronary artery disease diagnosis

Abstract Introduction Cardiovascular disease represents the foremost cause of death among chronic and non‐transmissible diseases. Diagnostic tools commonly used for peripheral and carotid atherosclerosis, such as ankle‐brachial index (ABI) and carotid ultrasonography (CU), may contribute as surrogates for the diagnosis of coronary arterial disease (CAD). Material and Methods We report a cross‐sectional study of 50 patients referred to elective invasive coronary angiography (ICA). Patients were submitted to ABI and CU—for carotid intima‐media thickness (CIMT) and carotid atherosclerotic plaque screening (CAPS). Clinical and demographic variables were also evaluated. CAD was defined as greater than 50% stenosis in at least one coronary artery. Results In logistic regression analysis, only CAPS showed a statistically significant area under the curve (AUC) for CAD prediction: 0.812 (95% CI, p <0.001). ABI and CIMT did not show statistically significant performance. For multivariate logistic regression analysis, the model including variables “gender,” “dyslipidemia,” “smoking,” “pack‐years,” and CAPS predicted CAD better. The AUC for this model was 0.912 (95% CI, p = 0.002). Conclusion The screening for carotid atherosclerotic plaques may enhance traditional risk stratification strategies for CAD. Longitudinal studies and bigger samples of subject are needed to allow extrapolation of our findings.