• 作者：Javier Elduayen Gragera ; Lorenzo Muñ ; oz Santos ; Juan M. Nogales Asensio ; ^{juanmanogales@yahoo.es} ; Fernando Gimé ; nez S&#225 ; ez ; José ; R. Ló ; pez Mí ; nguez ; Antonio Merch&#225 ; n Herrera
• 关键词：Í ; ndice tobillo-brazo ; Dolor torá ; cico ; Cardiopatí ; a isqué ; mica
• 刊名：Medicina Cl¨ªnica
• 出版年：2010
• 出版时间：20 February 2010
• 年：2010
• 卷：134
• 期：5
• 页码：202-205
• 全文大小：170 K

Background and objective

Acute chest pain (ACP) is a non-specific symptom that may be the expression of coronary artery disease (CAD). Atherosclerosis is usually present in more than one vascular territory. Ankle-brachial index (ABI) is a useful tool for the diagnosis of peripheral arterial disease (PAD). Our aim was to evaluate the value of ABI in patients with ACP when CAD is suspected.

Patients and methods

We performed a cross-sectional study of 94 patients, mean age: 57.4 (12.2), admitted consecutively due to ACP with suspicion of CAD. ABI and presence of CAD were determined.

Results

CAD was present in 22 patients (23.4 % ) and absent in 72 (76.6 % ). Asymptomatic PAD (ABI?.9) was present in 6 patients (27.2 % ) of CAD group and in 7 patients (9.7 % ) of the non-CAD group. Significant difference was found in ABI based on the presence or not of CAD [0.95 (0.23) vs 1.17 (0.15), p<0.001]. The diagnostic value of ABI for CAD detection was evaluated: area under the ROC curve was 0.8 (IC 95 % : 0.70?.87) and optimal cut-off point was 0.8 (sensitivity=22.7 % and specificity=98.6 % ). In the multivariate analysis, ABI was the best independent predictor of CAD (p<0.001).

Conclusion

ABI is a simple, cheap and efficient method, which complements other conventional diagnostic methods in the recognition of patients with ACP due to CAD.