Comparative Evaluation of Ankle–Brachial Index, Thrombolysis in Myocardial Infarction, and SYNTAX Scores in Predicting the Severity of Coronary Artery Disease

Objectives: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Early identification of disease severity is crucial for risk stratification and management. The ankle–brachial index (ABI) serves as a non-invasive marker of systemic atherosclerosis, the thrombolysis in myocardial infarction (TIMI) risk score estimates clinical risk in acute coronary syndromes, and the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score (SYNTAX) quantifies angiographic complexity. This study aimed to evaluate the correlation among ABI, TIMI, and SYNTAX scores in patients with angiographically proven CAD and to determine their association with the extent of coronary vessel involvement. Material and Methods: A cross-sectional study was conducted on 80 patients with angiographically confirmed CAD. The ABI was measured using a Doppler device (≤0.9 considered abnormal). The TIMI and SYNTAX scores were calculated using established criteria. Patients were categorized based on angiographic findings into single-vessel disease and multi-vessel disease (MVD). Associations were analyzed using the Chi-square test, with P < 0.001 considered statistically significant. Results: Among 80 patients (67.5% males), the predominant age group was 51–60 years. Diabetes (60%), dyslipidemia (61.25%), hypertension (56.25%), and smoking (62.5%) were prevalent. Low ABI (≤0.9), high TIMI (≥4), and high SYNTAX (>22) scores were significantly associated with MVD ( P < 0.001 for all). Conclusion: ABI, TIMI, and SYNTAX scores individually and collectively demonstrated significant correlations with CAD severity. Their combined application enhances risk stratification by integrating clinical, non-invasive, and angiographic parameters, particularly valuable in resource-limited settings.