AB1210 Ankle brachial index for the diagnosis of subclinical atherosclerosis using carotid intima media thickness in systemic lupus erythematosus patient in sanglah hospital
Authors: P.K. Kurniari, G. Kambayana, E. Dharmawan
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Atherosclerosis and its complications in Systemic Lupus Erythematosus (SLE) patients occurred more rapidly than the general population. Early detection of atherosclerosis is currently a challenge for clinicians. Angiography as a gold standard diagnosis of atherosclerosis is invasive, has a limitation. The surrogate marker carotid intima media thickness (CIMT) examination with B-mode ultrasonography has been used widely and validated. The limitation of this examination is operator dependence. Ankle brachial index (ABI) examination is simpler, cheaper, objective and widely available and is expected to be used for the diagnosis of subclinical atherosclerosis. <h3>Objectives</h3> to determine the sensitivity, specificity, positive predictive value and negative predictive values of the ABI to establish the diagnosis of subclinical atherosclerosis in SLE patients. <h3>Methods</h3> A cross sectional study was enrolling 56 subjects and was conducted from September 2016 to July 2017 at Sanglah Hospital, Denpasar, Bali, Indonesia. We used 2 × 2 cross table to determine the sensitivity, specificity, positive predictive value and negative predictive values of ABI to establish the diagnosis of subclinical atherosclerosis. <h3>Results</h3> Of the 56 samples, 48 people (85.7%) were female. The area under ROC curve was 0708 (70,8%), p=0041. ABI examination to diagnose subclinical atherosclerosis in patients with SLE with a cutoff value of 0.95 has a sensitivity of 70%, specificity of 76.1%, 38.9% positive predictive value, and negative predictive value of 92.1%. The best cut-off value of ABI as a diagnostic tool for subclinical atherosclerosis in SLE patients is &lt;0.95. <h3>Conclusions</h3> Examination with ABI can be considered as an alternative diagnostic when CIMT is not available. The diagnostic value of ABI is reliable enough for screening and diagnostic confirmation of subclinical atherosclerosis in patients with SLE. <h3>References</h3> [1] Westerweel PE, Luyten RK, Koomans HA, Derksen RH, Verhaar MC. Premature atherosclerotic cardiovascular disease in systemic lupus erythematosus. Arthritis &amp; Rheumatism2007; 56(5): 1384–1396. [2] Cacciapaglia F, Zardi EM, Coppolino G, Buzzulini F, Margiotta D, Arcarese L, et al. Stiffness Parameter, intima-media thickness and early atherosclerosis in systemic lupus erythematosus patients. Lupus2009:18;249–256. [3] Wu GC, Liu HR, Leng RX, Li XP, Li XM, Pan HF, et al. Subclinical atherosclerosis in patient with systemic lupus erythematosus: A systemic review and meta-analysis. Autoimmun Rev2016;15(1):22–37. [4] Manzi S. Prevalence and risk factors of carotid plaque in women with systemic lupus erythematosus. Arthritis Rheum2007;42:51–60. [5] 5. TheodoridouA, Bento L, D'Cruz DP. Prevalence and associations of an abnormal ankle-brachial index in systemic lupus erythematosus: a pilot study. Ann Rheum Dis 2003;62:1199-1203. [6] Kadarman JT, Anggriyani N, Wiryawan W. Perbandingan sensitivitas dan spesifisitas ankle brachial index dengan carotid intima-media thickness dalam mendeteksi penyakit jantung koroner signifikan. Jurnal Kedokteran Diponegoro2016; 5(4):1111–1124. <h3>Disclosure of Interest</h3> None declared