الفهرس 
VASCULAR BIOLOGY AND PATHOBIOLOGY OF VASCULAR DISEASE
Ankle brachial indexOnly 14 pages are availabe for public view
Abstract
Atherosclerosis is progressive and diffuse pathological
disorders which can simultaneously affect multiple
vascular beds, PAD often coexist with other manifestations of
systemic atherosclerotic process including CAD.
Diagnosing PAD in patients with CAD admitted to
cardiac rehabilitation program can help to tailor exercise
regimen to fit these patients, in addition, early treatment and/or
intervention may help to control progression of the disease.
Aim of the study is to search for the prevalence of
undiagnosed PAD using ankle brachial index in Egyptian
patients with documented CAD undergoing cardiac
rehabilitation program.
The study included 200 patients presented to Ain Shams
university hospitals with documented CAD starting from
January 2015 for detection of PAD using ABI with exclusion of
patients with known (diagnosed) PAD and Patients refusing the
test.
All patients were subjected to:
*History taking: stressing on
- Risk factors, details of CAD, and symptoms of claudication or
limb ischemia, in addition to medications. * Clinical examination; including palpation of peripheral pulses
in both lower limbs.
* 12 lead ECG
* Laboratory investigations:
Basic labs included CBC, renal functions and lipid
profile.
* Echocardiography, with emphasis on EF and SWMA at rest.
* Coronary angiography documentation for degree of CAD and
if any intervention has been done.
* ABI using Doppler ultrasonography.
patients were divided into two groups according to the
results of ABI measurements as follows:
Study group with positive ABI (≤0.9)
Control group with negative ABI (>0.9)
We found that the prevalence of undiagnosed PAD in
those patients was 14.5% (29 patients), and The incidence of
PAD is increased in patients with CAD with age above 60 years
(p=0.001) and in presence of history of HTN (p=0.000), DLP
(p=0.005), or family history of ischemic heart disease
(p=0.035), and in presence of uncontrolled SBP (p=0.002). PAD was associated with impaired left ventricular
systolic function and presence of SWMA.
There was a higher incidence of impaired eGFR among
patients with PAD.
There was a higher incidence of presenting with STEMI,
LAD affection and presence of ECG changes among patients
with low ABI.
So this study recommend ABI being simple inexpensive
non invasive available method to be done routinely in patients
with significant CAD for exclusion or diagnosis of PAD if
present as early diagnosis will help in treatment and improving
quality of life in addition to modification of cardiac
rehabilitation program in presence of PAD according to its
severity.