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Comparison of different methods of ABI acquisition for detection of peripheral artery disease in diabetic patients.

Authors
  • Homza, Miroslav1, 2
  • Machaczka, Ondrej3
  • Porzer, Martin1, 2
  • Kozak, Milan4
  • Plasek, Jiri1, 2
  • Sipula, David1, 2
  • 1 Department of Cardiovascular Diseases, University Hospital Ostrava, Czech Republic. , (Czechia)
  • 2 Department of Internal Medicine, Faculty of Medicine, University of Ostrava, Czech Republic. , (Czechia)
  • 3 Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Czech Republic. , (Czechia)
  • 4 Department of Internal Cardiology Medicine, Faculty of Medicine, Masaryk University Brno, Czech Republic. , (Czechia)
Type
Published Article
Journal
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
Publication Date
Sep 01, 2019
Volume
163
Issue
3
Pages
227–232
Identifiers
DOI: 10.5507/bp.2018.046
PMID: 30215436
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Ankle brachial index (ABI) is the principal screening method for peripheral arterial disease (PAD). In this study, we compare various types of Doppler-derived and oscillometric ABIs with results obtained through duplex ultrasonography. 62 patients were enrolled in the study. For each limb, blood pressures for both ankle arteries and the arm were measured using Doppler and an automated oscillometric device. Duplex ultrasound was performed for all limbs and occlusions >50% were considered PAD-positive. ABI was calculated using both higher (HABP) and lower (LABP) arterial blood pressure on the individual limbs and the ability to predict duplex-detected stenoses was evaluated. LABP calculation provided results superior to the guideline-recommended HABP. Considering patients with ABI >1.4 or measurement failure as PAD-positive further enhanced the test parameters. The higher ABI cut-off of 1.0 resulted in somewhat better sensitivities (max 92%) and negative predictive values (max 87%) at the expense of a substantial increase in the number of false positives. Oscillometric method yielded poor sensitivities but very good specificities (max 94%) and positive predictive values (max 90%). Doppler-based LABP provides better results than the guideline-recommended HABP in diabetic patients, nevertheless even this method is not perfect. Increasing the cut-off value to 1.0 in these patients does not bring a substantial improvement of the test performance. Patients with high ABI should be automatically considered PAD-positive and referred for further investigation using imaging techniques.

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