Femoral plaque burden by ultrasound is a better indicator of significant coronary artery disease over ankle brachial index.

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Tytuł:: Femoral plaque burden by ultrasound is a better indicator of significant coronary artery disease over ankle brachial index.
Autorzy:: Colledanchise KN; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.
Mantella LE; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.
Hétu MF; Division of Cardiology, Department of Medicine, Cardiovascular Imaging Network at Queen's, Queen's University, 76 Stuart Street, FAPC3, Kingston, ON, K7L 2V7, Canada.
Liblik K; Division of Cardiology, Department of Medicine, Cardiovascular Imaging Network at Queen's, Queen's University, 76 Stuart Street, FAPC3, Kingston, ON, K7L 2V7, Canada.
Abunassar JG; Division of Cardiology, Department of Medicine, Cardiovascular Imaging Network at Queen's, Queen's University, 76 Stuart Street, FAPC3, Kingston, ON, K7L 2V7, Canada.
Johri AM; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada. .; Division of Cardiology, Department of Medicine, Cardiovascular Imaging Network at Queen's, Queen's University, 76 Stuart Street, FAPC3, Kingston, ON, K7L 2V7, Canada. .
Źródło:: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2021 Oct; Vol. 37 (10), pp. 2965-2973. Date of Electronic Publication: 2021 Jul 09.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: [New York] : Springer
Original Publication: Boston : Kluwer Academic Publishers, c2001-
MeSH Terms:: Coronary Artery Disease*/diagnostic imaging
Peripheral Arterial Disease*/diagnostic imaging
Ankle Brachial Index ; Brachial Artery/diagnostic imaging ; Carotid Intima-Media Thickness ; Cross-Sectional Studies ; Femoral Artery/diagnostic imaging ; Humans ; Predictive Value of Tests ; Prospective Studies
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Grant Information:: CFI#29051 Ontario Research Fund; #ER15-11-029 Ministry of Research, Innovation and Science Early Research Award; Clinician Scientist Development Program Southeastern Ontario Academic Medical Organization; Clinician Scientist Phase I #7500 Heart and Stroke Foundation of Canada (CA)
Contributed Indexing:: Keywords: Ankle-brachial index; Atherosclerosis; Coronary artery disease; Femoral; Femoral ultrasound; Peripheral arterial disease; Vascular ultrasound
Entry Date(s):: Date Created: 20210709 Date Completed: 20211015 Latest Revision: 20211015
Update Code:: 20240105
DOI:: 10.1007/s10554-021-02334-9
PMID:: 34241751
: Czasopismo naukowe

The ankle-brachial index is a commonly used tool for identifying peripheral artery disease for cardiovascular risk stratification. An abnormal ankle-brachial index occurs only following extensive peripheral atherosclerosis occlusion, and thus has poor sensitivity for coronary atherosclerosis. There is a critical need for the development of tools that can detect risk prior to advanced stages of atherosclerosis. We sought to determine the sensitivity of femoral ultrasound for coronary artery disease. In this prospective, cross-sectional study, participants (n = 124) underwent ankle-brachial index measurement and femoral ultrasound for assessment of intima-media thickness, maximal plaque height, and total plaque area following coronary angiography. Receiver operating characteristic areas under the curve were plotted for identifying significant coronary artery disease (≥ 50% stenosis). Logistic regression was utilized to evaluate associations. 64% of participants had significant, angiography-confirmed coronary artery disease. Femoral ultrasound plaque area yielded the highest area under the curve for detecting significant coronary disease (area under the curve = 0.731). In contrast, an abnormal ankle-brachial index (≤ 0.90) produced an area under the curve of 0.568. Femoral ultrasound had a higher sensitivity (85%) than the ankle-brachial index (25%) for ruling out significant coronary artery disease. Both ankle-brachial index and femoral ultrasound have similar capacity to detect peripheral artery disease. Femoral ultrasound has a significantly greater discriminatory power than ankle-brachial index to detect clinically significant coronary artery disease. Ultrasound-captured femoral plaque burden directly delineates the extent of peripheral arterial disease and is better at ruling out significant coronary atherosclerosis than the ankle-brachial index.
(© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

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