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Vascular multimorbidity in patients with a documented coronary artery disease
1Department of Cardiology and Angiology, Heart Centre Coswig, Lerchenfeld 1, 06869 Coswig, Germany. lanzer@hcc.mediclin.de
Insights
Atherosclerotic artery disease often affects multiple vascular areas. This study found 31.8% of coronary artery disease patients had disease in other territories, with prevalence increasing with age. Type II diabetes was a key risk factor.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Epidemiology
Background:
- Atherosclerotic artery disease is a systemic condition affecting multiple vascular beds.
- Coronary artery disease (CAD) often coexists with disease in other major arteries.
Purpose of the Study:
- To determine the prevalence and distribution of non-coronary peripheral artery disease (PAD), cerebrovascular disease (CVD), and renal artery disease (RAD) in patients with confirmed CAD.
- To assess the relationship between CAD and multi-territory vascular disease, and identify associated risk factors.
Main Methods:
- A cross-sectional survey of 1855 inpatients with angiographically confirmed CAD.
- Patients were categorized into four age groups and analyzed by gender.
- Multivariate logistic regression was used to identify risk factors for multi-territory atherosclerosis.
Main Results:
- 31.8% of patients with CAD had significant disease in at least one other major vascular territory.
- Coronary artery disease was most frequently associated with PAD (9.5%).
- Multi-territory disease prevalence increased with age, but women aged 35-54 showed the highest prevalence of CAD with PAD and RAD.
Conclusions:
- Atherosclerotic disease commonly affects multiple vascular territories in patients with CAD.
- Age is a significant factor in multi-territory disease, but specific age/gender groups show unique patterns.
- Type II diabetes is the sole major risk factor identified for widespread atherosclerotic manifestation.
Abstract:
Atherosclerotic artery disease is a systemic vascular disorder typically involving multiple vascular territories in the same patient. To assess the prevalence and the topographic distribution of non-coronary peripheral artery disease (PAD), cerebrovascular (CVD) and renal artery disease (RAD) in patients with an angiographically confirmed coronary artery disease (CAD) a cross-sectional survey among inpatients admitted for symptoms of CAD was performed. The relationship between CAD and multiterritory vascular disease, and the major risk factors were also assessed. A total of 1855 consecutive patients, mean age 65 +/- 10.6 years (18-92 years), 1184 (63.8%) men and 671 (36.2%) women with an angiographically confirmed CAD were studied. The patients were divided into four age groups: group A < 35 years of age, group B 35 to 54 years, group C 55 to 74 years and group D > or =75 years of age. While 1265 (68.2%) had no evidence of a relevant non-coronary artery disease, in 590 (31.8%) a significant non-coronary artery disease in at least one additional major vascular territory was documented. CAD was most frequently associated with PAD in n = 176 (9.5%) patients. In 22 (1.2%), all four studied vascular territories were significantly diseased. The prevalence of the multi-territory artery disease increased with age: lowest in group A and highest in the group D. However, the data analysis by gender revealed the highest prevalence of CAD associated with PAD and RAD, respectively, in women 35 to 54 years of age. Using the multivariant logistic regression model, type II diabetes was the only major risk factor for a multi-territory expression of atherosclerosis.