The Relationship between Ankle- Brachial Index and Mortality in Patients with Acute Coronary Syndrome during Hospitalization and Six Months after Being Dismissed

Peripheral arterial disease (PAD) is associated with an increased risk of cardiovascular morbidity and mortality. Nevertheless, many patients are asymptomatic, and this condition frequently remains undiagnosed. An ankle-brachial index (ABI) of less than 0.9 is a nonintrusive and simple index in the diagnosis of ABI. The aim of this study was to assess the relationship between Ankle- Brachial Index and mortality in the patients affected with acute coronary symptom while they were hospitalized and six months after they were dismissed from the hospital. Also, the possible relationships between ABI and the traditional cardiovascular risk factors were examined. This is a prospective, cross-sectional study that was performed on 300 patients hospitalized in Farabi and Aria hospitals. The patients were diagnosed to be suffering from acute coronary syndrome (ACS). ABI was measured in all the patients and the questionnaires were filled out to evaluate the level of hospital mortality. Then all the patients’ status regarding the possibility of mortality was followed up through telephone contact six months after their dismissal from the hospital. In this study ABI < 0.9 was considered abnormal. The findings of this study revealed that 71% of the patients had unstable angina and 29% of them were suffering from myocardial infarction. Abnormal ABI (i.e. < 0.9) was found in 12.7% of all the patients. The rate of hospital mortality in subjects with ABI <0.9 was 18.4% which was significantly higher than that in normal subjects (2.3%) (P = 0.0001). The rate of mortality six months after hospital dismissal was estimated 10% 73.7% of whom had identified with abnormal ABI. This finding was also significantly higher than the finding concerning the dead patients with normal ABI (0.8%). In addition, a meaningful relationship was found between ABI and having a history of hyperlipidemia and high LDL cholesterol. Thus, hospitalized patients with coronary artery disease are likely to have Concomitant PAD and ABI should be measured in all patients with Coronary disease for prognosis purposes.