Type II Diabetes Mellitus and Its Dual Impact: Exploring the Connection with Coronary Artery and Peripheral Arterial Diseases

Background: Diabetes mellitus (DM) markedly increases the risk of macrovascular complications, such as peripheral arterial disease (PAD) and coronary artery disease (CAD). The Ankle-Brachial Index (ABI) is a noninvasive method for identifying PAD that may provide information about the severity of CAD. This study used the ABI and SYNTAX scores to investigate the connection between CAD and PAD in patients with type II diabetes. Methods: This cross-sectional prospective study involved one hundred individuals with type II diabetes who were having coronary angiography at Mansoura University. The severity of CAD and PAD was evaluated using SYNTAX scores and ABI measures, respectively. Results: ABI correlated inversely with SYNTAX scores, where patients with a normal ABI (≥0.9) had significantly lower SYNTAX scores compared to those with abnormal ABIs (p < 0.001). Specifically, 100% of patients with normal ABI had low SYNTAX scores. Conversely, in those with moderate abnormal ABI, 51.9% had high SYNTAX scores. The optimal ABI cutoff for detecting a SYNTAX score greater than 22 was 0.77, with a sensitivity of 96.3% and a specificity of 65.8%. Conclusion: ABI is a valuable predictor of CAD severity in type II DM patients, with lower ABI values indicating higher SYNTAX scores. This relationship supports the use of ABI in predicting more severe coronary artery involvement.