Screening for Peripheral Artery Disease Using the Ankle-Brachial Index

Abstract

Background: The literature surrounding the use of the ankle-brachial index (ABI) as a screening tool for peripheral artery disease (PAD) has evolved significantly over the years, reflecting an increasing recognition of its importance in cardiovascular health assessment. Literature Review: (Rosenbaum et al., 2012) expanded on ABI's role in cardiovascular risk assessment, particularly in populations with multiple risk factors, demonstrating that ABI can serve as an independent predictor of cardiovascular risk. Their findings, coupled with (Cavalcanti de Oliveira et al., 2015), who linked lower ABI values to more severe coronary artery disease, underscore ABI's utility beyond diagnosing PAD, positioning it as a marker for systemic atherosclerosis. (Hogan, 2019) further highlighted ABI's limitations regarding the localization of arterial blockages, advocating for a comprehensive diagnostic approach that may include additional testing modalities to enhance clinical decision-making. The reliability of ABI as a diagnostic tool was critically assessed by (Casey et al., 2019), who noted that operator skill and standardized protocols significantly influence measurement accuracy. This concern was echoed by (Tóth-Vajna et al., 2019), who explored the potential for false negatives in resting ABI assessments, particularly in primary care settings, emphasizing the need for improved diagnostic accuracy to reduce the incidence of undiagnosed PAD. Most recently, (L. Jagt et al., 2022) demonstrated that abnormal ABI results are predictive of future cardiovascular morbidity and mortality, further solidifying ABI's relevance in identifying patients at increased risk for adverse cardiovascular events. Conclusion: In conclusion, the body of literature collectively highlights ABI as a vital screening tool for PAD, while also emphasizing the need for careful interpretation of results and the incorporation of additional diagnostic methods to enhance clinical decision-making. The consensus underscores ABI's dual role as both a diagnostic and prognostic indicator, essential for the effective management of cardiovascular health, particularly in high-risk populations.