الفهرس 
AtherosclerosisOnly 14 pages are availabe for public view
 |  | from | 191 |  |  |
| | | from | 191 | | |
Abstract
The aim of this study was to correlate the ankle-brachial
Pressure index value (normal or low) with six-month clinical outcome in patients hospitalized for acute ST-segment elevation myocardial infarction.
This study was conducted at Mahalla Cardiac Center
And enrolled 60 patients with the first episode of acute ST- segment elevation myocardial infarction presenting to the coronary care unit.
All patients were subjected to the following:
1) - Careful history analysis.
2) - full clinical examination.
3) - The ankle-brachial pressure index was calculated with the duplex probe placed over the dorsalis pedis or posterior tibial artery.
4) – Patients categorized according to ankle-brachial
Pressure index values:
a- lower than or equal to 0.90 (abnormal ankle-brachial
Pressure index).
b- Higher than 0.90(normal ankle-brachial pressure index).
5) - At the time of discharge, all patients received the
Following medications, if there were no contraindications to any of them:
1- Angiotensin-converting enzyme inhibitors.
2- Beta-Blockers.
3- Acetyl salicylic acid.
4- Clopidogrel.
5- Statins.
Doses of these medications was accurately recorded for every patient
6) - Six-month clinical follow up included a follow up visit at the cardiac clinic. Major adverse cardiac events rates; were carefully reported.
Major adverse cardiac events include:
(a) Cardiovascular mortality.
(b) Fatal and non fatal myocardial reinfarction.
(c) Cerebrovascular stroke.
(d) Rehospitalization for an ischemic event.
They were divided into two groups as regard to ABI:
Group A: patients with normal ABI (> 0.9), they were 33 patients (55%), 8 were smokers (24.2%), 10 were diabetic (30.3%).
Group B: patients with abnormal ABI (≤ 0.9), they were 27 patients (45%), 17 were smokers (63%), 18 were diabetic (66.7%), and 5 patients with history of claudication pain (18.5%).
ABI and clinical outcome
Twenty of 27 patients with abnormal ABI (74.1%) had an outcome event as compared to 5 of 33 (15.2%) patients with normal ABI. The frequency of cardiovascular death was 22.2% in patients with abnormal ABI and 3.03% in those with normal ABI. Death from non cardiovascular cause occurred in 3.7 % of patients with abnormal ABI and in 0.0 % of those with normal ABI.
The linear association between ABI reduction and outcome events after adjusting for clinical groups was statistically significant.
At multivariate analysis, ABI was predictive of adverse outcome after adjustment for vascular risk factors in the logistic regression. This study indicated that an abnormal ABI is an independent risk factor for an adverse outcome in patients hospitalized for acute myocardial infarction.