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Stenotic coexistence among coronary, renal and extracrainal arteries in Chinese patients
Yuqiang Fang1, Xian Shu, Chenming Yang
1Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, 400042, People's Republic of China.
Insights
In Chinese patients, coronary artery disease often co-exists with stenosis in other arteries. Non-stenosis in coronary arteries predicts less stenosis elsewhere, while other artery stenosis suggests more coronary issues.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Epidemiology
Background:
- Coronary artery disease (CAD) is a significant health concern.
- Understanding the coexistence of stenosis in multiple arterial beds is crucial for risk stratification.
- Predictive relationships between coronary, renal, and extracranial artery stenosis require investigation in diverse populations.
Purpose of the Study:
- To investigate the prevalence and coexistence of stenotic lesions in coronary, renal, and extracranial arteries.
- To evaluate the predictive value of stenosis in one arterial system for stenosis in others among Chinese patients.
- To analyze these relationships in patients with diagnosed CAD or high CAD risk factors.
Main Methods:
- Angiographic evaluation of stenosis (≥50% diameter reduction) in 1,228 Chinese patients.
- Assessment of stenotic coexistence rates between the three arterial systems.
- Calculation of predictive values (stenosis and non-stenosis) and Cohen's Kappa for inter-arterial relationships.
Main Results:
- Coronary artery stenosis was most prevalent (48.5%), followed by extracranial (20.2%) and renal arteries (14.3%).
- Significant coexistence rates were observed: coronary-extracranial (14.3%), coronary-renal (10.9%), extracranial-renal (10.1%), and all three (2.69%).
- Non-stenosis of coronary arteries predicted lower stenosis in renal and extracranial arteries, while stenosis in these peripheral arteries predicted higher coronary stenosis.
Conclusions:
- Non-stenosis of the coronary artery is a significant indicator of reduced stenosis in extracranial and renal arteries in Chinese patients with CAD or risk factors.
- Stenosis in extracranial or renal arteries serves as an indicator for increased coronary artery stenosis.
- These findings highlight the interconnectedness of vascular beds and inform risk assessment strategies.
Abstract:
To investigate the stenotic coexistence among coronary, renal and extracranial arteries and check the predictive value of stenosis between these arteries in Chinese patients. The stenosis of three arteries was evaluated by angiography in 1,228 Chinese patients with clinically diagnosed coronary artery disease (CAD) or high CAD risk factors. Based on the criteria of stenotic diameter of ≥50%, we found that the rate of stenosis for the coronary artery was highest (48.5%), extracranial artery stenosis rate was intermediate at 20.2% and the renal artery with the stenosis rate of 14.3% was the lowest. The stenotic coexistence rates were 14.3% between the coronary and extracranial arteries, 10.9 % between coronary and renal arteries, 10.1% between the extracranial and renal arteries, and only 2.69% among all three arteries. The stenosis predictive value of the coronary artery for extracranial or renal arteries was lower, but the non-stenosis predictive value was higher. The predictive value of extracranial or renal artery for coronary artery stenosis was higher, while the non-stenosis predictive value was lower. Both the stenosis and non-stenosis predictive values were higher between the extracranial and renal arteries. Cohen's Kappa value was less than 0.40 between coronary and extracrainal or renal artery but more than 0.40 between extracranial and renal artery. The results were similar when the criteria of stenosis were judged as ≥75 or ≥25% respectively. We also did analysis within the subgroups with hypertension, diabetes, stroke and transient ischemia attach, got similar results. For Chinese patients with clinically diagnosed CAD or with highly risk factors, non-stenosis of the coronary artery is indicative of reduced stenosis of the extracranial and renal arteries, while extracranial or renal arteries stenosis is indicative of increased coronary artery stenosis.