Objective: To study the association between ankle brachial index (ABI) and microvascular complications in type 2 diabetes (T2DM) patients with coronary arterial disease (CAD).

Methodology: A retrospective study was carried on 3,468 T2DM patients who gave ABI test between 2002 and 2019. ABI status was defined as normal (1.0-1.4) and abnormal (<1.0 and >1.4). The distribution of patients was given in percentages. The logistic regression was used to study ABI status, microvascular complications and CAD risk factors (hypertension, age, BMI, smoking etc) role on CAD, and the resulted odds ratio (OR) was given with 95% CI and p-value.

Results: Patients were classified based on history of CAD, with, G1 (334), and without, G2 (3134). In G1, 69% patients were normal ABI and 31% abnormal. Across G1 and G2, neuropathy was populated with 37% (1279), nephropathy, 8% (293), hypertension, 15% (507) and hypothyroidism, 8% (270). The ABI abnormality was high in nephropathy (G1: 41%; G2: 29%) than neuropathy (G1: 34%; G2: 27%). Age wise, 60 and 70% of patients in neuropathy and nephropathy, respectively, were >60 years and shown increased ABI abnormality with age. The logistic model had revealed that patients with nephropathy, OR-1.8 [1.26-2.58], p-0.001 and abnormal ABI, OR-1.27 [95% CI, 0.99-1.63], p-0.059 were likely to have positive CAD outcome, i.e., both are associated. While neuropathy, OR-0.69, [0.54 - 0.90], and hypertension, OR-0.43 [0.33 - 0.57] were not contributing towards CAD in our study population.

Conclusion: T2DM patients with abnormal ABI were predicted to have 27% of increased odds of CAD outcome and this was increased to 80% in presence of nephropathy. Thus, following the onset of diabetes, albuminuria screening along with ABI measurement are suggested.


S. Trehan: None. R. Chawla: None. S. Jaggi: None. A. S: None. S. Palukuri: None. S. Deka: None. B.M. Makkar: Advisory Panel; Self; Abbott, AstraZeneca, Biocon, Boehringer Ingelheim Pharmaceuticals, Inc., Eris Lifesciences, Novartis AG, Novo Nordisk Inc., Sanofi, USV Private Limited. Speaker’s Bureau; Self; Janssen Pharmaceuticals, Inc.

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