Ankle brachial index intensifies the diagnostic accuracy of epicardial fat thickness for the prediction of coronary artery disease complexity.
OBJECTIVE
Epicardial fat thickness (EFT) and Ankle brachial index (ABI) are associated with coronary artery disease (CAD). The SYNTAX score (SS) reflects the complexity of CAD. We aimed to evaluate the relation of EFT and ABI with CAD complexity.


METHODS
We enrolled 197 patients undergoing coronary angiography. In all patients, ABI and EFT were determined. SS was calculated. The relationship between EFT, ABI and SS was analysed.


RESULTS
ABI and EFT were significantly correlated with SS (r = -0.525, p < 0.001, and r = 0.650, p < 0.001, respectively) and found to be independent predictors of SS. ABI<0.9mm identified patients with SS>22 with a sensitivity of 45.28% and a specificity of %82.64 (AUC = 0.689, %95 CI = 0.619-0.763, p<0.001). The optimal cutoff value for EFT was 5mm, yielding a sensitivity of 81.1% and a specificity of 90.3% (AUC = 0.859, 95% CI 0.802-0.904). In order to identify which parameters were the most accurate, we compared both AUC of ROC curves and there was no difference (p = 0.170).


CONCLUSIONS
EFT and ABI enables the noninvasive prediction of CAD severity in patients with suspected CAD and combining ABI to EFT was additive for the prediction of coronary artery disease complexity.
Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey. Electronic address: ahmetaykan@yahoo.com.
Ahmet Çağrı
AÇ
Aykan
Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
Ilker
I
Gül
Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
Tayyar
T
Gökdeniz
Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
Engin
E
Hatem
Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
Ahmet Oğuz
AO
Arslan
Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
Ezgi
E
Kalaycıoğlu
Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
Turhan
T
Turan
Department of Cardiology, Gaziemir Nevvar Salih İşgören State Hospital, Izmir, Turkey.
Erdal
E
Belen
Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
Mustafa
M
Çetin
D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D055109:Ankle Brachial Index; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging / Q000473:pathology*; D011446:Prospective Studies; D012720:Severity of Illness Index
Angiography; Ankle brachial index; Coronary; Epicardial fat thickness; Peripheral artery disease; SYNTAX