The Relationship between SYNTAX Score and Resting/Post-exercise Ankle-Brachial index in Patients with Acute Coronary Syndrome

Abstract

Background: The aim of this study is to determine the relationship between the complexity of coronary artery disease (CAD), determined by the SYNTAX score, and the resting and post-exercise Ankle-Brachial Index (ABI).

Materials and Methods: Patients who were treated for Acute Coronary Syndrome (ACS) were evaluated in our study. The correlation and predictive relationship between the ABI and the the complexity of CAD were evaluated by pearson and Logistic regression analysis.

Results: The mean age of 118 patients was 57.50±11.19 years and 26 (22%) patients were female. In the group with SYNTAX Score>22, lower resting ABI (p <0.001) and post-exercise ABI (p <0.001) were observed, whereas the higher SYNTAX II PCI (p= 0.005) score was found. As a result of the ROC analysis: resting ABI cut-off value was detected as 0,935 with a sensitivity of 75% and a specificity of 75% [p<0.001; AUC(95% CI)= 0,786 (0,697-0,875)] and post-exercise ABI cut-off value was detected as 0,945 with a sensitivity of 80% and a specificity of 81% to predict SYNTAX score >22 [p <0.001; AUC (95% CI)= 0,836 (0,761-0,912)]. Diabetes mellitus [p = 0.041; OR (95% CI)=1.901 (0.691-5.233)], resting ABI [p<0.001; OR(95% CI)= 2.702 (1.357-7.504)] and post-exercise ABI [p<0.001; OR(95% CI)= 2.968 (1.488-7.980)] were found to be independent predictors for the complexity of CAD.

Conclusion: In ACS patients, post-exercise ABI measurements have a stronger diagnostic power than resting ABI measurements in predicting CAD complexity. ABI measures at resting and post-exercise are independent  predictors of CAD complexity in ACS patients.