Comparison of Vessel Disease and Gensini Score according to Ankle-Brachial Index in Patients with Cardiovascular Disease

심혈관 질환자의 발목-상완 지수에 따른 Vessel disease 및 Gensini score 비교 융복합 연구

  • 최숙경 (서울아산병원 심장내과) ;
  • 최혜란 (울산대학교 임상전문간호학)
  • Received : 2016.10.06
  • Accepted : 2017.01.20
  • Published : 2017.01.28


The purpose of this study was to evaluate the clinical availability of ankle-brachial index(ABI) according to severity of cardiovascular disease. The subjects of this study were the patients who had ABI in a general hospital. In this study, total 441 patients were enrolled for analysis. Electric medical records were reviewed to investigate the result of ABI and severity of cardiovascular disease measured vessel disease and Gensini score. Collected data were analyzed using SPSS 21.0 program. Subjects with $ABI{\leq}0.90$ and > 0.90 were classified as having abnormal and normal ABI. There were significant differences in vessel disease categorization($x^2=4.731$, p=.030) and Gensini score(t=2.351, p=.019) between two groups. Therefore, ABI is an effective and non-invasive tool for the diagnosis of cardiovascular disease with high severity. ABI is a valuable predictive index of ischemic heart disease.


Ankle-brachial index;Cardiovascular disease;Coronary angiography;Vessel disease;Gensini score


  1. Korean Statistical Office, Cause of death statistics 2012. Retrieved November 27, 2013, from
  2. H. M. Dalal, A. Zawada, K. Jolly, T. Moxham, R. S. Taylor, "Home based versus centre based cardiac rehabilitation : Cochrane systematic review and meta-analysis", British Medical Journal, Vol. 340, pp. b5631, 2010.
  3. Y. S. Choi, "Comparison in nursing needs of heart disease patient depending on whether or not readmitted", Journal of Digital Convergence, Vol. 12, No. 6, pp. 519-526, 2014.
  4. T. Thom, N. Haase, W. Rosamond, V. J. Howard, J. Rumsfeld, T. Manolio, Z. J. Zheng, K. Flegal, C. O'Donnell, S. Kittner, D. Lloyd-Jones, D. C. Goff, Jr, Y. Hong, R. Adams, G. Friday, K. Furie, P. Gorelick, B. Kissela, J. Marler, J. Meigs, V. Roger, S. Sidney, P. Sorlie, J. Steinberger, S. Wasserthiel-Smoller, M. Wilson, P. Wolf, "Heart disease and stroke statistics-2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee", Circulation, Vol. 113, No. 6, pp. e85-e151, 2006.
  5. S. Nakata, Y. Yokoi, R. Matsumoto, N. Shirai, R. Otsuka, K. Sugioka, H. Yoshitani, S. Ehara, T. Kataoka, M. Yoshiyama, "Long-term cardiovascular outcomes following ischemic heart disease in patients with and without peripheral vascular disease", Osaka City Medical Journal, Vol. 54, No. 1, pp. 21-30, 2008.
  6. V. Aboyans, M. H. Criqui, P. Abraham, M. A. Allison, M. A. Creager, C. Diehm, F. G. Fowkes, W. R. Hiatt, B. Jönsson, P. Lacroix, B. Marin, M. M. McDermott, L. Norgren, R. L. Pande, P. M. Preux, H. E. Stoffers, D. Treat-Jacobson, "Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association", Circulation, Vol. 126, No. 24, pp. 2890-2909, 2012.
  7. C. Formosa, A. Gatt, N. Chockalingam, "Screening for peripheral vascular disease in patients with type 2 diabetes in Malta in a primary care setting", Quality in Primary Care, Vol. 20, No. 6, pp. 409-414, 2012.
  8. M. Sebastianski, S. Narasimhan, M. M. Graham, O. Toleva, J. Shavadia, S. Abualnaja, R. T. Tsuyuki, M. S. McMurtry, "Usefulness of the ankle-brachial index to predict high coronary SYNTAX scores, myocardium at risk, and incomplete coronary revascularization", The American Journal of Cardiology, Vol. 114, No. 11, pp. 1745-1749, 2014.
  9. M. H. Criqui, R. L. McClelland, M. M. McDermott, M. A. Allison, R. S. Blumenthal, V. Aboyans, J. H. Ix, G. L. Burke, K. Liu, S. Shea, "The ankle-brachial index and incident cardiovascular events in the MESA(Multi-Ethnic Study of Atherosclerosis)", Journal of the American College of Cardiology, Vol. 56, No. 18, pp. 1506-1512, 2010.
  10. S. G. Ahn, H. S. Lim, D. Y. Joe, S. J. Kang, B. J. Choi, S. Y. Choi, M. H. Yoon, G. S. Hwang, S. J. Tahk, J. H. Shin, "Relationship of epicardial adipose tissue by echocardiography to coronary artery disease", Heart, Vol. 94, No. 3, pp. 1-6, 2008.
  11. C. Sinning, L. Lillpopp, S. Appelbaum, F. Ojeda, T. Zeller, R. Schnabel, E. Lubos, A. Jagodzinski, T. Keller, T. Munzel, C. Bickel, S. Blankenberg, "Angiographic score assessment improves cardiovascular risk prediction: the clinical value of SYNTAX and Gensini application", Clinical Research in Cardiology, Vol. 102, No. 7, pp. 495-503, 2013.
  12. G. G. Gensini, "A more meaningful scoring system for determining the severity of coronary heart disease", The American Journal of Cardiology, Vol. 51, No. 3, pp. 606, 1983.
  13. I. J. Neeland, R. S. Patel, P. Eshtehardi, S. Dhawan, M. C. McDaniel, S. T. Rab, V. Vaccarino, A. M. Zafari, H. Samady, A. A. Quyyumi, "Coronary angiographic scoring systems: An evaluation of their equivalence and validity", American Heart Journal, Vol. 164, No. 4, pp. 547-552, 2012.
  14. C. Lahoz, J. M. Mostaza, "Ankle-brachial index: a useful tool for stratifying cardiovascular risk", Revista Espanola de Cardiología, Vol. 59, No. 7, pp. 647-649, 2006.
  15. O. S. Lee, M. G. Kim, S. H. Ha, "Interactive image segmentation for ultrasound vascular imaging", Journal of the Korea Convergence Society, Vol. 3, No. 4, pp. 15-21, 2012.
  16. A. Enoch, A. Ijeoma, "The role of ankle-brachial index as a screening test for coronary artery disease in the Hispanic population", Southern Medical Journal, Vol. 101, No. 11, pp. 1117-1120, 2008.
  17. C. M. Papamichael, J. P. Lekakis, K. S. Stamatelopoulos, T. G. Papaioannou, M. K. Alevizaki, A. T. Cimponeriu, J. E. Kanakakis, A. Papapanagiotou, A. T. Kalofoutis, S. F. Stamatelopoulos, "Ankle-brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease", The American Journal of Cardiology, Vol. 86, No. 6, pp. 615-618, 2000.
  18. B. R. Koh, Y. K. Kim, S. M. Ahn, K. E. Song, S. H. Jung, H. J. Kim, D. J. Kim, Y-S. Chung, K. W. Lee, "Relationship between diabetic peripheral vascular disease and ankle-brachial index", Journal of Korean Society of Endocrinology, Vol. 21, No. 5, pp. 382-388, 2006.
  19. S. S. Kweon, M. H. Shin, K. S. Park, H. S. Nam, S. K. Jeong, S. Y. Ryu, E. K. Chung, J. S. Choi, "Distribution of the ankle-brachial index and associated cardiovascular risk factors in a population of middle-aged and elderly Koreans", Journal of Korean Medicine Science, Vol. 20, No. 3, pp. 373-378, 2005.
  20. H. J. Kim, "Utility of brachial-ankle pulse wave velocity, ABI, AI as independent predictor of cardiovascular disease in Korean type2 DM patients", Unpublished master's thesis, Yonsei university, 2005.
  21. Y. J. Lee, S. J. Lee, C. G. Kim, "Korean adolescents' weight control behaviors by BMI(body mass index) and body shape perception-Korea Youth Risk Behavior web-based Survey from 2010", Journal of Digital Convergence, Vol. 10, No. 3, pp. 227-232, 2012.
  22. S. Tanaka, K. Kamiya, T. Masuda, N. Hamazaki, R. Matsuzawa, K. Nozaki, E. Maekawa, C. Noda, M. Yamaoka-Tojo, A. Matsunaga, J. Ako, "Low ankle brachial index is associated with the magnitude of impaired walking endurance in patients with heart failure", International Journal of Cardiology, Vol. 224, pp. 400-405, 2016.
  23. P. J. Scanlon, D. P. Faxon, A. Audet, B. Carabello, G. J. Dehmer, K. A. Eagle, R. D. Legako, D. F. Leon, J. A. Murray, S. E. Nissen, C. J. Pepine, R. M. Watson, J. L. Ritchie, R. L. Gibbons, M. D. Cheitlin, T. J. Gardner, A. Garson, Jr, R. O. Russell, Jr, T. J. Ryan, S. C. Smith, Jr, "ACC/AHA guidelines for coronary angiography", Journal of the American College of Cardiology, Vol. 33, No. 6, pp. 1756-1824, 1999.
  24. L. Y. He, J. F. Zhao, J. L. Han, S. S. Shen, X. J. Chen, "Correlation between serum free fatty acids levels and Gensini score in elderly patients with coronary heart disease", Journal of Geriatric Cardiology, Vol. 11, No. 1, pp. 57-62, 2014.
  25. T. P. Murphy, R. Dhangana, M. J. Pencina, R. B. D'Agostino, "Ankle-brachial index and cardiovascular risk prediction: An analysis of 11,594 individuals with 10-year follow-up", Atherosclerosis, Vol. 220, No. 1, pp. 160-167, 2012.
  26. C. Espinola-Klein, H. J. Rupprecht, C. Bickel, K. Lackner, S. Savvidis, C. M. Messow, T. Munzel, S. Blankenberg, "Different calculations of ankle-brachial index and their impact on cardiovascular risk prediction", Circulation, Vol. 118, No. 9, pp. 961-967, 2008.
  27. Y. Igarashi, T. Chikamori, S. Hida, H. Tanaka, C. Shiba, Y. Usui, T. Hatano, A. Yamashina, "Importance of the ankle-brachial pressure index in the diagnosis of coronary artery disease in women with diabetes without anginal pain", Circulation Journal, Vol. 75, No. 9, pp. 2006-2212, 2011.
  28. H. M. Su, W. C. Voon, T. H. Lin, K. T. Lee, C. S. Chu, M. Y. Lee, S. H. Sheu, W. T. Lai, "Ankle-brachial pressure index measured using an automated oscillometric method as a predictor of the severity of coronary atherosclerosis in patients with coronary artery disease", Kaohsiung Journal of Medical Sciences, Vol. 20, No. 6, pp. 268-272, 2004.
  29. J. H. Kim, M. Y. Rhee, Y. S. Kim, J. H. Bae, D. Y. Nah, Y. K. Kim, M. M. Lee, C. Lim, C. J. Kim, "Brachial-ankle pulse wave velocity for the prediction of the presence and severity of coronary artery disease", Clinical and Experimental Hypertension, Vol. 36, No. 6, pp. 404-409, 2014.
  30. M. Bosevski, I. Peovska, "Clinical usefulness of assessment of ankle-brachial index and carotid stenosis in type 2 diabetic population-three-year cohort follow-up of mortality", Angiology, Vol. 64, No. 1, pp. 64-68, 2013.
  31. Y. Ueki, T. Miura, Y. Miyashita, H. Motoki, K. Shimada, M. Kobayashi, H. Nakajima, H. Kimura, H. Akanuma, E. Mawatari, T. Sato, S. Hotta, Y. Kamiyoshi, T. Maruyama, N. Watanabe, T. Eisawa, S. Aso, S. Uchikawa, N. Hashizume, N. Sekimura, T. Morita, S. Ebisawa, A. A. Izawa, J. Koyama, U. Ikeda, "Predictive value of combining the anklebrachial index and SYNTAX score for the prediction of outcome after percutaneous coronary intervention(from the SHINANO Registry)", The American Journal of Cardiology, Vol. 117, No. 2, pp. 179-185, 2016.
  32. H. Y. Lee, "The Analysis of Pulse Wave Velocity of Jeju female divers", Journal of Digital Convergence, Vol. 13, No. 9, pp. 515-521, 2015.