Would you favor additional work-up for abnormally elevated ABIs that suggest noncompressible vessels to confirm the presence of PAD?

Any ABI greater than 1.4 is due to calcification of the blood vessels. This is abnormal, and the risk of MI, Stroke, and CV death is increased in these individuals. Therefore, I would treat them as if they had peripheral artery disease and would go for an LDL below 55. I would not necessarily do fur...

For patients with non compressible vessels (patients with DM, CKD for example), the use of a toe-brachial index (TBI) is the preferred choice to diagnose underlying PAD.

Arterial calcification and/or "stiff" blood vessels are by far the most common causes of ABI greater than 1.4, but elevated ABI can also be seen in hyperdynamic states, such as severe anemia, thyrotoxicosis, or chronic severe aortic regurgitation. These possibilities should be considered in patients...