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Carotid and lower extremity arterial disease in acute myocardial infarction
M Scudlová1, C Cíhalík, A Hyzák
11st Department of Internal Medicine, University Hospital, Palacký University, Olomouc, Czechoslavakia.
Insights
This study found that over half of patients with acute myocardial infarction have significant arterial disease in their carotid arteries or lower extremities, often without symptoms. Hypercholesterolemia was the most common risk factor observed.
Area of Science:
- Vascular Medicine
- Cardiology
- Diagnostic Imaging
Background:
- Acute myocardial infarction (AMI) is a leading cause of mortality worldwide.
- Patients with AMI often have co-existing atherosclerotic disease in other vascular beds.
- Early detection of vascular disease can inform risk stratification and management.
Purpose of the Study:
- To investigate the prevalence of carotid arterial disease (CAD) and peripheral arterial disease (PAD) in patients with AMI.
- To assess the association between vascular changes and cardiovascular risk factors.
- To determine the proportion of asymptomatic arterial lesions in this patient cohort.
Main Methods:
- Noninvasive ultrasound examinations were performed on 111 patients diagnosed with AMI.
- Ultrasound assessed the carotid arteries and arteries of the lower extremities.
- Data on cardiovascular risk factors, including hypercholesterolemia, were collected and analyzed.
Main Results:
- Carotid arterial disease was detected in 41% of patients, with 85% being asymptomatic.
- Peripheral arterial disease was found in 39% of patients, often bilateral.
- Associated atherosclerotic lesions in both locations were present in 14% of patients.
- Patients with vascular changes averaged 3 or more risk factors.
- Hypercholesterolemia was the most frequent risk factor (79%).
- Overall, 64% of AMI patients exhibited peripheral vascular changes.
Conclusions:
- A significant proportion of patients with acute myocardial infarction have underlying carotid and/or peripheral arterial disease.
- These vascular abnormalities are frequently asymptomatic, highlighting the need for comprehensive vascular screening.
- Hypercholesterolemia is a major risk factor associated with these widespread atherosclerotic changes.
Abstract:
The authors present the results of noninvasive ultrasound examinations of the carotid and the arteries of the lower extremities in 111 patients with acute myocardial infarction. Carotid arterial disease was detected in 45 (41%). In 85% it was asymptomatic, haemodynamically significant lesions of the internal carotid artery were asymptomatic in more than half of the patients. Peripheral arterial disease was found in 43 patients (39%); it was bilateral in three fourths of them. Asymptomatic findings were present in 42%. Associated atherosclerotic lesions in both vascular locations were demonstrated in 16 patients (14%). On the average, patients with vascular changes had 3 risk factors and more. The most frequent risk factor was hypercholesterolaemia (79%) which was, at the same time, the most pronounced risk factor in patients with as well as without vascular changes. On the whole, peripheral vascular changes were found in 71 patients (64%) with acute myocardial infarction.