Association of SYNTAX score, ankle-brachial index, and toe-brachial index with peripheral arterial disease following CABG.

Abstract

Background: Peripheral arterial disease (PAD) is a common comorbidity in patients undergoing coronary artery bypass grafting (CABG) and is associated with increased morbidity. Early identification of PAD in this population is clinically important; however, the relationship between coronary disease complexity and peripheral arterial involvement remains unclear.This study aimed to evaluate the association of the SYNTAX score, ankle-brachial index (ABI), and toe-brachial index (TBI) with the development of peripheral arterial disease following CABG.

Methods: In this retrospective study, 87 patients who underwent CABG were evaluated four years after surgery for the presence of PAD. Baseline SYNTAX score, ABI, and TBI were measured prior to CABG. PAD was diagnosed based on clinical symptoms in combination with abnormal ABI and/or TBI findings and was confirmed by Doppler ultrasonography when indicated. Associations between SYNTAX score, ABI, TBI, and PAD were analyzed using appropriate statistical tests.

Results: During the follow-up period, 7 patients (8.0%) developed PAD. Diabetes mellitus was significantly more prevalent among patients with PAD compared to those without PAD (85.7% vs. 45.0%, P = 0.039). Right ABI (P = 0.005), left TBI (P = 0.008), and right TBI (P = 0.010) were significantly associated with PAD, whereas left ABI was not. Although the SYNTAX score was not directly associated with PAD incidence, higher SYNTAX scores were significantly correlated with greater reductions in both left ABI (r = -0.296, P = 0.005) and right ABI (r = -0.220, P = 0.040) 4 years after CABG.

Conclusion: Peripheral arterial disease following CABG was significantly associated with diabetes mellitus and with lower ABI and TBI values, particularly in the right lower extremity. While the SYNTAX score was not directly associated with PAD occurrence, it was correlated with longitudinal declines in ABI, suggesting an association between coronary disease complexity and systemic vascular dysfunction.