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Polyvascular extracoronary atherosclerotic disease in patients with coronary artery disease

Tadeusz Przewłocki1, Anna Kabłak-Ziembicka, Artur Kozanecki

  • 1Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Collegium Medicum, The John Paul II Hospital, Krakow, Poland. tadeuszprzewlocki@op.pl

Kardiologia Polska
|September 29, 2009
PubMed

Insights

Significant atherosclerosis affects 36% of patients with coronary artery disease (CAD). Factors like smoking, high creatinine, and female gender predict polyvascular atherosclerosis (PVA) in these patients.

Area of Science:

  • Cardiovascular Medicine
  • Atherosclerosis Research
  • Vascular Disease Epidemiology

Background:

  • Cardiovascular diseases are a leading cause of death globally, with increasing prevalence of coronary artery disease (CAD), peripheral arterial disease (PAD), supra-aortic arterial disease (SAD), and renal stenosis (RAS).
  • Polyvascular atherosclerosis (PVA), affecting multiple arterial territories, significantly worsens cardiovascular outcomes.

Purpose of the Study:

  • To investigate the prevalence, coexistence, and predictors of significant PAD, SAD, and RAS in individuals suspected of having CAD.
  • To understand the extent of atherosclerosis beyond the coronary arteries in a patient cohort undergoing coronary angiography.

Main Methods:

  • Analysis of angiography data from 687 consecutive patients (mean age 63.5 years) undergoing coronary angiography.
  • Stenosis of >=50% in CAD, SAD, PAD, and RAS was quantified.
  • Logistic regression analysis identified independent predictors of multi-territory PVA.

Main Results:

  • Significant CAD was detected in 79.3% of patients.
  • Extracoronary atherosclerosis was prevalent: SAD in 19.8%, RAS in 8%, and PAD in 15%.
  • Independent predictors for at least 2-territory PVA included multivessel CAD, hyperlipidemia, smoking, elevated creatinine, lower extremity claudication, and female gender.

Conclusions:

  • A substantial proportion (36%) of patients with documented CAD also exhibit significant atherosclerosis in extracoronary arteries.
  • The presence and severity of PVA correlate with an increased burden of atherosclerosis risk factors and a history of atherothrombotic events.
Abstract

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