Background:

Smoking increases the risk of peripheral arterial disease (PAD) by 1.9 to 3.4 times by inducing endothelial dysfunction and alterations in lipid metabolism and coagulation.

Objective:

To evaluate the association between the smoking index (SI) and clinical severity of PAD using the ankle-brachial index (ABI) and Fontaine classification.

Method:

Retrospective cohort study in PAD patients. Demographic variables, SI (high SI defined as ≥ 15 pack-years), and ABI were analyzed. Mann-Whitney U test, chi-square test, and Spearman’s correlation were applied (p < 0.05 considered significant).

Results:

Among 50 patients (80% male), 78% had a high SI. A moderate negative correlation was found between SI and left ABI (rho: –0.42; p < 0.002), suggesting greater severity in heavy smokers. No statistically significant association was observed between SI and Fontaine stages (p = 0.27).

Conclusions:

A significant association was identified between smoking intensity and PAD severity based on ABI, but not with Fontaine clinical classification.

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