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AB1210 Ankle brachial index for the diagnosis of subclinical atherosclerosis using carotid intima media thickness in systemic lupus erythematosus patient in sanglah hospital
  1. P.K. Kurniari,
  2. G. Kambayana,
  3. E. Dharmawan
  1. Internal medicine, Udayana University/Sanglah General Hospital, Bali, Indonesia

Abstract

Background 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.

Objectives 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.

Methods 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.

Results 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 <0.95.

Conclusions 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.

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Disclosure of Interest None declared

  • SLE
  • Subclinical Atherosclerosis
  • ABI
  • CIMT.

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