PERBANDINGAN SENSITIVITAS DAN SPESIFISITAS ANKLE-BRACHIAL INDEX DENGAN CAROTID INTIMA-MEDIA THICKNESS DALAM MENDETEKSI PENYAKIT JANTUNG KORONER SIGNIFIKAN

Abstract

Background : The current gold standard for the diagnosis of Coronary Artery Disease (CAD) is coronary angiography. Not all the patients can undergo coronary angiography procedure, because of its contrast agent, furthermore it is an invasive procedure and the patient is exposed to radiation. Therefore, it is necessary to use another safer diagnostic device with minimal side effects for detection of CAD. Ankle-Brachial Index (ABI) and Carotid Intima-Media Thickness (CIMT) are simple noninvasive tools without radiation exposure and both have good correlation with CAD. Aim : To compare the diagnostic value of ABI and CIMT for diagnosing significant CAD. Methods : The subject of the study consist of 60 people who had been performed a coronary angiography procedure in Permata Medika Hospital Semarang. The data used in the study were primary and secondary data. ABI was measured by oscillometric method and the normal value is 0,9 to 1,3; while CIMT was measured by ultrasonography, normal value is less than 0,9 mm, was access in common carotid artery and carotid bulb. This was a diagnostic test study to compare ABI and CIMT with the gold standard coronary angiography procedure for detection of significant CAD. Results : Compared to coronary angiography, ABI has sensitivity 35,71% and specificity 94,44% in detecting significant CAD. The diagnostic test result of common carotid artery CIMT sensitivity and specificity respectively is 73,81% and 77,78%; while in carotid bulb, the sensitivity is 95,24% and specificity is 61,11%. Conclusion : ABI and CIMT are simple noninvasive tools which can be used to detect significant CAD. The most sensitive test is CIMT which was examined in the carotid bulb, whereas ABI is the most specific one. Keywords : coronary artery disease, coronary angiography, ankle-brachial index, carotid intima-media thickness