Significance of ankle brachial index as a predictor of presence and severity of coronary artery disease in dyslipidemia patients

Background: Dyslipidemia is a major contributor to systemic atherosclerosis and coronary artery disease (CAD). The ankle-brachial index (ABI) is a simple, non-invasive indicator of peripheral arterial disease and global atherosclerotic burden. Aim: To evaluate the significance of ABI as a predictor of the presence and angiographic degree of CAD in cases with dyslipidemia. Methods: This prospective cross-sectional research involved 100 dyslipidemic cases with suspected CAD undergoing elective coronary angiography. All patients underwent detailed clinical assessment, laboratory investigations, ECG, echocardiography, and ABI measurement. CAD severity was assessed using coronary angiography and quantified by the Gensini score. Correlations between ABI, cardiovascular risk factors, and Gensini score have been analyzed. Receiver operating characteristic (ROC) curves have been applied to estimate the diagnostic performance of ABI. Results: The mean age was 66.4 ± 11.6 years, with 62% males. Multivessel CAD was present in 69% of cases. Mean ABI was 0.61 ± 0.35, and mean Gensini score was 50.9 ± 24.8. ABI showed significant negative correlations with age, BMI, total cholesterol, triglycerides, LDL-C, and Gensini score (r = −0.77, p below 0.001). An ABI cutoff > 0.76 discriminated single-vessel from multivessel disease with excellent accuracy (AUC = 0.97, sensitivity 93.5%, specificity 92.8%). Gensini score also effectively predicted abnormal ABI (AUC = 0.847). Conclusion: ABI is a strong, non-invasive predictor of both the presence and degree of CAD in dyslipidemic cases. Routine ABI assessment may enhance cardiovascular risk stratification and guide earlier, more aggressive management.