title: [Ankle-brachial index: which clinical use?].
abstract: The ankle-brachial index (ABI) obtained by the ankle/brachial blood pressure ratio is the gold standard for the diagnosis of peripheral arterial disease (PAD): ≤0.9 is the cut-off value for PAD diagnosis and ≤0.4 for the diagnosis of acute or chronic critical limb ischemia. Recently, the ABI has been proposed as an independent marker of cardiovascular (CV) risk, but its role remains debated. According to some authors, ABI improves CV risk scoring when added to traditional scores, such as the Framingham risk score, in both primary and secondary prevention: an ABI of ≤0.9 or ≥1.4 can allow for the selection of a subset of patients at high CV risk even if asymptomatic. On the contrary, others reported that ABI does not always improve CV risk scoring and, most importantly, optimization of therapy does not result in reduced rates of CV events. Side effects due to aggressive therapy were found to be more clinically relevant than the advantages deriving from a better control of CV risk. This review was aimed at defining the role of ABI as the gold standard for PAD screening and diagnosis, and as an independent early marker of CV risk, namely of coronary risk, taking into account the pros and cons reported in the literature.
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi, Firenze.
authors.forename: Luca
authors.initials: L
authors.lastname: Naldi
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi, Firenze.
authors.forename: Margherita
authors.initials: M
authors.lastname: Bernetti
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi, Firenze.
authors.forename: Francesca
authors.initials: F
authors.lastname: Baroni
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi, Firenze.
authors.forename: Maria
authors.initials: M
authors.lastname: Boddi
mesh_terms: D055109:Ankle Brachial Index / Q000379:methods; D006801:Humans; D058729:Peripheral Arterial Disease / Q000175:diagnosis*