Ankle Brachial Index Intensifies the Diagnostic Accuracy of Epicardial Fat Thickness for the Prediction of Coronary Artery Disease Complexity

ObjectivesEpicardial fat thickness (EFT) and Ankle brachial index (ABI) are associated with coronary artery disease (CAD). The SYNTAX score (SS) reflects the complexity of CAD. We aimed to evaluate the relation of EFT and ABI with CAD complexity.MethodsWe enrolled 197 patients undergoing coronary angiography. In all patients, ABI and EFT were determined. SS was calculated. The relationship between EFT, ABI and SS was analysed.ResultsABI and EFT were significantly correlated with SS (r = -0.525, p < 0.001, and r = 0.650, p < 0.001, respectively) and found to be independent predictors of SS.ABI<0.9 mm identified patients with SS>22 with a sensitivity of 45.28% and a specificity of %82.64 (AUC = 0.689, %95 CI = 0.619-0.763, p<0.001). The optimal cutoff value for EFT was 5 mm, yielding a sensitivity of 81.1% and a specificity of 90.3% (AUC = 0.859, 95% CI 0.802–0.904). In order to identify which parameters were the most accurate, we compared both AUC of ROC curves and there was no difference (p = 0.170).ConclusionEFT and ABI enables the noninvasive prediction of CAD severity in patients with suspected CAD and combining ABI to EFT was additive for the prediction of coronary artery disease complexity.