Concomitant peripheral vascular and coronary artery disease: a new dimension for the global endovascular specialist?
Gianluca Rigatelli1, Loris Roncon, Emiliano Bedendo
1Interventional Cardiology Unit, Division of Cardiology, Rovigo General Hospital, Rovigo, Italy. jackyheart@hotmail.com
Insights
Significant abdominal vessel disease is common in patients with coronary artery disease (CAD). This highlights the need for a comprehensive cardiovascular assessment in elderly patients with multiple risk factors and multivessel CAD.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Radiology
Background:
- Peripheral atherosclerosis diagnosis is crucial for managing patients with coronary artery disease (CAD).
- Assessing abdominal vessel disease alongside coronary angiography is important for a holistic patient view.
Purpose of the Study:
- To determine the prevalence and clinical significance of abdominal vessel stenosis or aneurysm (AVA) in patients undergoing coronary angiography.
- To identify predictors of AVA in this patient population.
Main Methods:
- Retrospective analysis of medical records from 504 consecutive patients undergoing coronary angiography at two institutions over 12 months.
- Evaluation of angiographic results for patients who also underwent abdominal aorta angiography.
Main Results:
- Abdominal vessel disease (AVA) was present in 35.7% of patients.
- Prevalence included renal artery stenosis (13.1%), aortoiliac artery disease (13.7%), and aortic aneurysmal disease (8.9%).
- Independent predictors for AVA were >=3-vessel CAD, age >65, and >=3 risk factors.
Conclusions:
- Multiple atherosclerotic distributions are frequent in elderly patients with multivessel CAD and high-risk profiles.
- Suggests the utility of a comprehensive cardiovascular approach for these patients.
Background:
Early and accurate diagnosis of peripheral atherosclerosis is of paramount importance for global ma agement of patients with known coronary artery disease (CAD).
Hypothesis:
We sought to evaluate retrospectively the prevalence and clinical relevance of significant abdominal vessel stenosis or aneurysm (AVA) in patients undergoing coronary angiography.
Methods:
Medical records of consecutive patients who underwent coronary angiography at two public institutions over a 12-month period were evaluated. Angiographic results of patients who underwent diagnostic abdominal aorta angiography, based on clinical criteria, to evaluate abdominal vessels the same time as coronary angiography were analyzed.
Results:
During the study period, AVA was reported in 180 (35.7%) of 504 consecutive patients (335 men, mean age 68 +/- 13.8 years): renal artery stenosis was found in 13.1% of cases (66 patients), aortoiliac artery disease in 13.7% (69 patients and aortic aneurysmal disease in 8.9% (45 patients). Logistic regression analyses revealed > or = 3-vessel CAD (odds ratio [OR] 9.917, p = 0.002), age >65 years (OR 3.817, p = 0.036), > or =3 risk factors (OR 2.8, p = 0.048) as independent predictors of AVA.
Conclusion:
Multiple vascular atherosclerotic distributions are frequent in elderly patients who have multivessel CAD and a high-risk profile, suggesting the usefulness of a more global and comprehensive cardiovascular approach.
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