Ayşenur Özderya, Fatma Dilek Dellal, Yal MUTLU NİYAZOĞLU, ERTUĞRUL TAŞAN, Ayşenur ÖZDERYA, Fatma Dilek DELLAL, Yalçın HACIOĞLU, Fatih Öner KAYA, Mutlu NİYAZOĞLU, Ertuğrul TAŞAN

Measurment of Ankle-Brachial Pressure Index, Homocystein Level, and Evaluation of Coronary Artery Disease Association with Other Macrovascular Diseases in Patients with Myocardial Infarction

We aimed to measure ankle-brachial pressure index (ABPI) and homocysteine levels, and to evaluate frequency of cerebrovascular disease (CVD) and/or peripheral arterial disease (PAD) combination of patients with myocardial infarction (MI). 39 patients (26 males, 13 females) with acute or subacute MI and 36 control cases (9 male, 27 female) were included in the study. ABPI and homocysteine levels were measured, and bilateral carotid-vertebral and bilateral lower extremity arterial Doppler ultrasonography, and coronary angiography were examined. Homocysteine was significantly higher in patient group than control group (p=0.0001). The ABPI was not significantly different in two groups (p=0.428). However the frequency of patients with lower ABPI (â¤0.9) was significantly higher compared to the frequency of control patients with lower ABPI (25.6% and 3%, respectively; p=0.02). The combination of the atherosclerotic findings in the carotid artery and coronary artery disease (CAD) were found significantly higher compared to that of the bilateral lower extremity (59%, 25.6%). Screening of CVD should be done in patients with MI history. Determining carotid arterial lesions may be useful for the early diagnosis and treatment of any possible CVD in cases with CAD. Studies with larger numbers of cases are needed.

Keywords:

myocardial infarction, cerebrovascular disease, peripheral arterial disease, ankle-brachial pressure index, homocysteine, C reactive protein, fibrinogen,

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1. Al-Qaisi M, Nott MD, King DH, Kaddoura S. Ankle brachial pressure index (ABPI): An update for practitioners. Vasc Health Risk Manag. 2009;5:833-41.
2. Wild SH, Byrne CD, Smith FB, Lee AJ, Fowkes FG. Low ankle-brachial pressure index predicts increased risk of cardivascular disease independent of the metabolic syndrome and conventional cardiovacsular risk factors in the Edinburgh Artery Study. Diab Care. 2006;29(3):637-42.
3. O'Grady H, Kelly C, Bouchier-Hayes D, Leahy A. Homocysteine and occlusive arterial disease. Br J Surg. 2002;89(7):838-44.
4. Gauthier GM, Keevil JG, McBride PE. The association of homocysteine and coronary artery disease. Clin Cardiol. 2003;26(12):563-8.
5. Thiengburanatham S. Hyperhomocysteinemia-induced myocardial injury after coronary artery bypass. Asian Cardiovasc Thorac Ann. 2009;17(5):483-9.
6. Casas JP, Shah T, Hingorani AD, Danesh J, Pepys MB. C-reactive protein and coronary heart disease: a critical review. J Intern Med. 2008;264(4):295-314. 7. Peripheral arterial disease in people with diabetes. American Diabetes Association. Diab Care. 2003;26(12):3333-41.
8. Dieter RS, Tomasson J, Gudjonsson T, Brown RL, Vitcenda M, Einerson J, McBride PE. Lower extremity peripheral arterial disease in hospitalized patients with coronary artery disease. Vasc Med. 2003;8(4):233-6.
9. Sukhija R, Aronow WS, Yalamanchili K, Peterson SJ, Frishman WH, Babu S. Association of ankle-brachial index with severity of angiographic coronary artery disease in patients with peripheral arterial disease and coronary artery disease. Cardiol. 2005;103(3):158-60.
10. Kiernan TJ, Taqueti V, Crevensten G, Yan BP, Slovut DP, Jaff MR. Correlates of carotid stenosis in patients undergoing coronary artery bypass grafting – a case control study. Vasc Med. 2009;14(3):233-7.
11. Fisicaro M, Da col PG, Tonizzo M, Fonda M, Bollini M, Cattin L. Early carotid atherosclerosis in asymptomatic adults with primary moderate hypercholesterolemia. Atherosclerosis. 1994;106(2):255-61.
12. Adams MR, Nakagomi A, Keech A, Robinson J. Carotid intima-media thickness is only weakly correlated with the extent and severity of coronary artery disease. Circulation. 1995;92(8):2127-34.
13. Merino J, Planas A, De Moner A, Gasol A, Marrugat J, Vidal-Barraquer F, Clarà A. The association of peripheral arterial occlusive disease with major coronary events in a mediterranean population with low coronary heart disease incidence. Eur J Vasc Endovasc Surg. 2008;36(1):71-6.
14. Uzun Ş, Vural H, Uzun M, Baysan O. The use of ankle-brachial index, an easily obtained physical examination finding, in predicting the severity of coronary heart disease. Gulhane Med J. 2005;47(4):279-81.
15. Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation. 2003;107(3):363-9.
16. Heinrich J, Assmann G. Fibrinogen and cardiovascular risk. J Cardiovasc Risk. 2005;2(3):197-205.
17. Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA. 1995;274(13):1049-57.
18. Stampfer MJ, Malinow MR, Willett WC, Newcomer LM, Upson B, Ullmann D, Tishler PV, Hennekens CH. A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA. 1992;268(7):877-81.
19. Nygård O, Vollset SE, Refsum H, Stensvold I, Tverdal A, Nordrehaug JE, Ueland M, Kvåle G. Total plasma homocysteine and cardiovasculer risk profile. JAMA. 1995;274(19):1526-33.
20. Ubbink JB, Van Der Merwe A, Vermaak WJH, Delport R. Homocysteinemia and response to vitamin supplements. Clin Investing. 1993;71(12):993-8.
21. Tokgözoğlu SL, Alikaşifoğlu M, Unsal, Atalar E, Aytemir K, Ozer N, Ovünç K, Usal O, Kes S, Tunçbilek E. Methylene tetrahydrofolate reductase genotype and the risk and extent of coronary artery disease in a population with low plasma folate. Heart. 1999;81(5):518- 22.