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Prevalence and clinical outcome of polyvascular atherosclerotic disease in patients undergoing coronary intervention

Takashi Miura1, Yoshimitsu Soga, Tatsuki Doijiri

  • 1Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. miuramen10 miuramen@yahoo.co.jp

Circulation Journal : Official Journal of the Japanese Circulation Society
|September 29, 2012
PubMed

Insights

Polyvascular disease (polyVD) affects nearly 28% of patients undergoing percutaneous coronary intervention (PCI). Patients with polyVD face significantly higher risks of major adverse cardiovascular events (MACE), with risks escalating with more affected arterial beds.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Polyvascular disease (polyVD) involves multiple arterial territories, including lower extremity, carotid, renal arteries, and abdominal aortic aneurysm.
  • Patients undergoing percutaneous coronary intervention (PCI) may have co-existing polyVD, impacting their cardiovascular risk.
  • Understanding the prevalence and outcomes of polyVD in PCI patients is crucial for risk stratification and management.

Purpose of the Study:

  • To determine the prevalence of polyVD in patients undergoing PCI.
  • To evaluate the association between polyVD and major adverse cardiovascular events (MACE) after PCI.
  • To assess how the extent of polyVD influences MACE risk.

Main Methods:

  • Prospective enrollment of 1,597 patients undergoing PCI.
  • Simultaneous evaluation of carotid, renal, peripheral arteries, and abdominal aorta using duplex ultrasound and ankle-brachial index.
  • Primary endpoint defined as MACE (cardiovascular death, myocardial infarction, stroke).

Main Results:

  • PolyVD was identified in 446 of 1,597 patients (27.9%).
  • MACE were significantly higher in the polyVD group (12.1%) compared to those with coronary artery disease alone (3.8%).
  • Cardiovascular death and stroke incidence were significantly elevated in the polyVD group, with risk increasing proportionally to the number of affected arterial beds.

Conclusions:

  • A high incidence of MACE exists in PCI patients with polyVD.
  • The risk of MACE increases significantly with the number of affected arterial beds in patients with polyVD undergoing PCI.
Abstract

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