Screening of asymptomatic carotid atherosclerosis in diabetic patients and its association with ankle-brachial index

Czech version

Authors: Homza M. ¹; Machaczka O. ²; Porzer M. ^1,3; Kozák M. ⁴; Plášek J. ^1,2; Šipula D. ^1,2
Authors‘ workplace: Katedra interních oborů, LF OU, Ostrava ¹; Ústav epidemiologie a veřejného zdraví, LF OU, Ostrava ²; Kardiovaskulární oddělení, FN Ostrava ³; Interní kardiologická klinika LF MU a FN Brno ⁴
Published in: Kardiol Rev Int Med 2019, 21(1): 24-28

Overview

Asymptomatic carotid atherosclerosis remains a relatively controversial topic with respect to both interventional therapy and recommendations for the use of diagnostic ultrasound. In our study, a group of high risk diabetic patients attending a cardiovascular clinic was examined using duplex ultrasound for carotid atherosclerosis and the results were compared with lower extremity arterial disease (LEAD) and the ankle-brachial index (ABI) obtained using the lower of ankle pressures. Carotid atherosclerosis was detected in 87.1% of patients, 27.4% of which had a stenosis of more than 50%, and significant stenosis (i.e., greater than 70%) was detected in 9.7% of patients. These numbers were even higher in the group of patients over 60 years of age. We also revealed a strong relationship between LEAD and significant carotid stenosis as well as between the ABI value, calculated using the lower arterial pressure, and significant carotid stenosis. No patient with normal ABI and no patient without LEAD had significant carotid stenosis. Hence, we conclude that it is beneficial to perform ABI measurement using Doppler ultrasound method and lower arterial pressure at the ankle level that can also serve, as well as the LEAD screening, as a useful tool for determining whether or not a duplex examination of carotids should be performed in the particular patient.

Keywords:

atherosclerosis – carotids – ankle-brachial index – ABI – lower extremity arterial disease – peripheral arterial disease – duplex ultrasonography

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