The diagnostic and prognostic importance of the Ankle Brachial Index in primary care: a prospective, single-centre study

Peripheral Arterial Disease is a manifestation of systemic atherosclerosis that is commmon in the general population and is associated with an increased risk of death and ischemic events, yet it is underdiagnosed in clinical practice. Originally described by Winsor in 1950, the Ankle Brachial Index (ABI) was initially proposed for the non invasive diagnosis of lower-extremity peripheral artery disease (PAD). Later, it was also shown that the ABI is an indicator of atherosclerosis at other vascular sites and can serve as a prognostic marker for cardiovascular events and functional impairment, even in the absence of symptoms of PAD. So, the ABI has a diagnostic and prognostic importance, and it allows the general practitioner to perform an early diagnosis of PAD and subsequent prevention of cardiovascular events. Early diagnosis and prevention are the two pillars of general practice. Still, the ABI is rarely performed. The aim of this project is demonstrating the usefulness and the relevance of the ABI in General Practice through a prospective, single-centre study of 207 patients from Bereguardo general practice clinic without a previous history of Atherosclerotic Cardiovascular Disease (ASCVD). With this study we calculate the prevalence of asymptomatic PAD, highlighting how many diagnoses would not be made if the ABI were not measured, and we also demonstrate in which patient category (according to age and risk factors) it is best to measure the ABI, in order to efficiently carry out a preventive or treatment plan which is fully patient-tailored, so as to reduce as many future cardiovascular events as possible.

L'importanza diagnostica e prognostica dell'Indice Caviglia Braccio nella medicina di base: uno studio prospettico e monocentrico