Sensitivity and Specificity of Ankle-Brachial Index for Detecting Angiographic Stenosis of Peripheral Arteries
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概要
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Background The aim of the present study was to prospectively evaluate the sensitivity, specificity, positive and negative likelihood ratios (LR+, LR-) of the ankle-brachial index (ABI), using conventional digital subtraction angiography (DSA) as the reference standard, in the assessment of lower extremity arteries, and to research the threshold value of the ABI in diagnosing periphery arterial disease (PAD), as well as the relationship between the ABI value and stenosis in the artery of the lower extremity in Chinese high-risk cardiovascular patients. Methods and Results A total of 298 consecutive patients (199 men, 99 women, 64.9±11.3 years old) underwent conventional DSA and ABI measurement. Receiver operator characteristics (ROC) analysis was performed to assess possible threshold values that predict PAD in these patients. The greater the stenosis in the artery of the lower extremity, the lower the measured ABI value. DSA was used as the gold standard in defining lesions ≥30%, ≥50%, and ≥70% and the respective areas under the ROC curve were 0.786 (95% confidence interval (CI) 0.712, 0.860), 0.927 (95% CI 0.869, 0.984), and 0.963 (95% CI 0.927, 0.999). Conventional DSA was the gold standard in defining ≥50% luminal stenosis for the diagnosis of lower extremity PAD. The 0.95 is the overall cutoff of the ABI that was associated with 91% sensitivity, 86% specificity, 6.5 LR+ and 0.1 LR- for detection of hemodynamically significant stenosis (lesions ≥50%) in all 298 subjects (p<0.001). Conclusion The ABI value shows a decreasing tendency with increasing severity of stenosis in patients with PAD. ABI measurement is an accurate and reliable noninvasive alternative to conventional DSA in the assessment of lower extremity arteries and the cut-off of 0.95 is the threshold ABI value for detecting PAD in Chinese patients.
- 社団法人日本循環器学会の論文
- 2008-03-20
著者
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Hu Dayi
中華人民共和国
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LI Jue
Heart-Lung-Blood Vessel Center of Tongji Universty, Institute of Heart-Lung-Blood Vessel Disease of
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HU Dayi
Heart-Lung-Blood Vessel Center of Tongji University, Institute of Heart-Lung-Blood Vessel Disease of
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Li Jue
Department Of Cardiology Tongji Hospital Of Tongji University
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Hu Dayi
Heart Center People's Hospital Of Peking University People's Republic Of China
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Hu Dayi
Heart Lung And Blood Vessel Centre Tongji University
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Zhao Mingzhong
Heart, Lung and Blood Vessel Center, Tongji University
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Luo Yingyi
Heart Lung And Blood Vessel Centre Tongji University
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Li Jue
Heart Lung And Blood Vessel Center Of Tongji University
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Zhao Mingzhong
Heart Lung And Blood Vessel Center Tongji University
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GUO Xiaoming
Department of Cardiology, Tongji Hospital of Tongji University
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Guo Xiaoming
Heart, Lung and Blood Vessel Center, Tongji University
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Pang Wenyue
Department of Cardiology, The Second Affiliated of China Medical University
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Luo Yingyi
Shanghai Institute of Health Sciences
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Sun Yingxian
Department of Cardiology, The Second Affiliated of China Medical University
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Pang Wenyue
Department Of Cardiology The Second Affiliated Of China Medical University
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Guo Xiaoming
Department Of Cardiology Tongji Hospital Of Tongji University
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Li Jue
Heart Lung And Blood Vessel Center Tongji University
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Sun Yingxian
Department Of Cardiology The Second Affiliated Of China Medical University
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Hu Dayi
The College Of Medicine Tongji University
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