Prevalence of Asymptomatic Peripheral Artery Disease in Patients Undergoing Coronary Artery Bypass Grafting

1.1. Purpose: The Ankle-Brachial Index (ABI) is an efficient tool to determine the presence of lower-extremity Peripheral Artery Disease (PAD). It is an important marker for risk stratification in patients with Coronary Artery Disease (CAD) and predicts mortality and morbidity in CABG procedures. The presence of a subclinical occlusive PAD is associated with a three-fold excess risk of a subsequent cardiovascular event after CABG. Assessment of PAD is simple, reproducible, and cost-effective to detect lower-extremity arterial stenosis to identify patients risk undergoing CABG. The aim of this study was to determine the frequency of PAD in patients undergoing CABG at a tertiary care hospital in South Asian region. 1.2. Materials: After ethical review committee review all elective patients undergone isolated CABG were prospectively recruited for 18 months. Information was collected on demographics, co-morbidities. Systolic pressures in the posterior tibial and the dorsalis pedis arteries at each ankle were measured using the standard algorithm recommended by the American Heart Association. Mean of ABI of 1.0 to 1.4 is considered as normal and <0.9 suggests PAD. 1.3. Results: A total of 151 patients were consecutively recruited. Mean age of the patients was 54.4 ± 6.4 years and mean BMI was 28.8 ± 1.8. Males were dominant 137 (90.7%). Mean ABI was 1.29 ± 0.21 (range from 0.7 to 1.6). Prevalence of PAD was found to be 10% (n=15). Proportion of smoker was comparable 51%, however, hypertension 106 (70.2%) and dyslipidemia 111 (73.5%) were high in PAD positive group. 1.4. Conclusion: The prevalence of a symptomatic PAD was 10% in isolated CABG candidates. Screening of PAD through ABI is a proven important clinical marker for risk stratification in patients with CAD. Pre-CABG procedure diagnosis of PAD is important to monitor the efficacy of revascularization procedures of lower extremities. It also provides important prognostic information about future cardiovascular events. Use of ABI is recommended for risk assessment of the patients undergoing lower extremity revascularization procedures.