Exercise stress ankle brachial index in the diagnosis of peripheral artery disease among patients with low, intermediate and high framingham risk profile / Maribel C. Gonzales-Tanque, Norberto Tuaño

Background: Peripheral artery disease (PAD) is a common manifestation of atherosclerosis and is characterized by increasing incidence of morbidity and mortality. It is a powerful predictor of cardiovascular and cerebrovascular events associated with increase in mortality thereby making early detection of this disease fundamental. This study aims to determine the use of exercise stress ankle brachial index in the diagnosis of peripheral artery disease among patients with different Framingham risk categories. Method: This is a prospective cross-sectional study conducted at the Philippine Heart Center from September 2011 to December 2011. Subjects included were stratified using Framingham risk score. Claudication was identified using the Edinburgh Questionnaire. The subjects underwent stress ABI determination. The Framingham risk categories were correlated with the result of the stress ABI. Results: A total of 81 patients were enrolled in the study. Forty-eight percent of the population were male with an average age of 61 years. Among the associated co-morbidities, hypertension was present in the majority of the study population (72%) followed by diabetes mellitus (57%). Eighty-six percent of patients with intermittent claudication and 64% of patient who had history of cigarette smoking had positive stress ABI, which are both statistically significant (p-value of 0.00 and 0.017 respectively). All the Framingham risk categories failed to show statistically significant correlation with abnormal stress ABI. Conclusion: This study demonstrated that almost all patients with intermittent claudication had abnormal stress ABI. Regardless of the Framingham risk category, stress ABI should be performed in patients with this symptom. Smoking history also showed a statistically significant correlation with PAD and it is reasonable to perform stress ABI among this group of patients.

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