DIGNOSTIC ACCURACY OF ANKLE BRACHIAL INDEX OVER LOWER LIMB ARTERIAL DOPPLER SONOGRAPHY TO EVALUATE PERIPHERAL ARTERIAL DISEASE IN DIABETIC AND HYPERTENSIVE PATIENTS.

Peripheral vascular disease (PVD) is a common cause of morbidity and mortality amongst diabetic (DM) and hypertensive (HTN) subjects. PVD can be diagnosed if there is hemodynamically signicant obstruction on arterial doppler (AD) ultrasonography, or, if the Ankle Brachial Index (ABI) < 0.9. Though, any PVD can be conrmed by AD, it is, however, time consuming and not always accessible for early screening. To ass Objective – ess the diagnostic accuracy of ABI compared with AD for evaluation of severity and duration of PVD in DM and HTN patients. Methodology - A cross sectional study was conducted among 72 patients (40-75 years) with 21 (29%) having HTN, 24 (33%) having DM and 27 (38%) having both, for suspected PVD assessment by both AD and ABI. Correlation between ABI and AD ndings was done after detailed clinical history, physical and local examination, ABI assessment by sphygmomanometer and linear ultrasound probe, AD evaluation of peripheral arteries of lower limbs and other relevant examinations was done as necessitated. ABI had an accuracy of 80%, a sensitivity of 76.6%, a specicity of 88%, a positive p Result - redictive value of 92.3%, and a negative predictive value of 66.6%. DM (81%) and people with both (DM and HTN) (81.3%) were found to have higher sensitivity compared to those with HTN (60%) when evaluated with ABI. It was found that there was a positive correlation between the duration of DM (r=0.86, P=0.00001), HTN (r=0.76, P =0.00006) or both (r=0.64, P=0.003) with the severity of arterial disease as calculated by AD and by ABI (r=0.68, P=0.0002) in DM, (r=0.73, P=0.0001) in HTN, and (r=0.69, P=0.0006) in both. Thus, implying a strong correlation between the duration and severity of PVD involvement as evaluated by ABI and AD. Conclusion- ABI is an effective, non-invasive, early screening tool for PVD.