title: Importance of the ankle-brachial pressure index in the diagnosis of coronary artery disease in women with diabetes without anginal pain.
abstract: BACKGROUND
  Clinical symptoms of coronary artery disease (CAD) are often atypical in women, particularly in those with diabetes mellitus. Therefore, a simple diagnostic test to identify a high-risk subset of women with diabetes who are likely to have CAD is important.
  
  
  RESULTS
  A total of 407 consecutive patients (319 men and 88 women, age range 68 ± 11 years) with suspected CAD, who were not complaining of anginal pain, were evaluated. Among these patients, 170 had diabetes. Stress myocardial perfusion imaging and simultaneous brachial and ankle blood pressure measurements were performed to obtain the ischemic total perfusion deficit (TPD) and ankle-brachial pressure index (ABI), respectively. Ischemic TPD was not significantly different between men and women, whereas ischemic TPD was significantly greater in diabetic patients than in non-diabetic patients (6.9 ± 7.7% vs. 4.9 ± 6.1%; P = 0.005). In diabetic patients, ischemic TPD was not significantly different between men and women. However, women with ABI<0.9 showed significantly greater ischemic TPD than those with ABI≥0.9 (12.1 ± 10.8% vs. 5.1 ± 5.9%; P=0.04), whereas no difference in ABI was observed in men.
  
  
  CONCLUSIONS
  ABI was useful in evaluating CAD in asymptomatic women with diabetes to detect a high-risk subset showing the ischemic TPD of >10%, which is regarded as a scintigraphic indicator for coronary revascularization.
authors.affiliation: Department of Cardiology, Tokyo Medical University, Tokyo, Japan. yuko50@tokyo-med.ac.jp
authors.forename: Yuko
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Taishiro
authors.initials: T
authors.lastname: Chikamori
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hida
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Chie
authors.initials: C
authors.lastname: Shiba
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Usui
authors.forename: Tuguhisa
authors.initials: T
authors.lastname: Hatano
authors.forename: Akira
authors.initials: A
authors.lastname: Yamashina
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012727:Sex Characteristics