Prevalence of Abnormal Ankle-brachial Index (ABI) Test High Among Patients Who Are Otherwise Not Considered at Risk of Coronary Heart Disease by Framingham Risk Score
The prevalence of abnormal ankle-brachial index (ABI) test results among individuals tested for peripheral arterial disease (PAD)—and who are not considered at high risk of a coronary heart event by Framingham-based risk factors—is high and provides another way to identify those who may be at risk for future heart attacks, say researchers at the Society of Interventional Radiology's 35th Annual Scientific Meeting in Tampa, Fla.
"Any methods to improve identification of individuals who are otherwise not considered at high risk for heart attack—based on Framingham risk factors—would have significant public health impact," said Timothy P. Murphy, M.D., FSIR, an interventional radiologist and director of the Vascular Disease Research Center at Rhode Island Hospital in Providence. "With the help of the simple ankle-brachial index (ABI) test, a comparative blood pressure reading in the arm and ankle that is used to screen for peripheral arterial disease, thousands of lives can possibly be saved," he added. "This type of novel risk factor can positively impact public health by improving risk prediction," said Murphy. Interventional radiologists can partner with primary care doctors, who may not be aware of—or able to administer—noninvasive tests like the ABI in managing patients' vascular disease, he explained. "Since ABI screening is not routinely performed, a large number of individuals are not being identified as high risk and, thus, not being treated for their risk factors. Interventional radiologists can work with primary care doctors in evaluating patients' risk for cardiovascular disease as well as by managing established PAD," added Murphy.
Coronary heart disease is the leading cause of death in the United States. About 1.1 million Americans suffer heart attacks each year and almost one-third of those heart attacks result in death. Risk factors such as smoking, diabetes, high blood pressure, high blood cholesterol and obesity are associated with increased risk of heart attack and are routinely monitored by doctors to identify at-risk patients. However, about two-thirds of coronary events occur in individuals not known to be at high risk of such events. Methods to improve identification of individuals who are otherwise not considered at high risk based on Framingham risk factors would have significant public health impact. "Early detection is paramount. Primary preventions, such as initiating lifestyle changes and medical intervention directed at modifying risk factors (smoking cessation, blood glucose and blood pressure control, lowering cholesterol and exercise)—can be started before costlier and more intensive interventions are needed," said Murphy, co-author of "Prevalence of Abnormal Ankle-Brachial Index Among Subjects With Low–intermediate Framingham Risk Score."