Study of Angiographic Relationship between Peripheral Arterial Diseases with the Involvement of Specific Coronary
S A Habib1, M N Islam, M F Rahman
1Dr SM Ahsan Habib, Associate Professor, Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Insights
Patients with peripheral artery disease (PAD) often have undiagnosed coronary artery disease (CAD). Angiography in PAD patients can reveal significant coronary artery involvement, guiding necessary cardiovascular interventions.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Interventional Cardiology
Background:
- Peripheral artery disease (PAD) affects lower limbs and is associated with increased cardiovascular risk.
- Coronary artery disease (CAD) is a major cause of morbidity and mortality in patients with PAD.
- The extent and pattern of CAD in PAD patients often remain undiagnosed.
Purpose of the Study:
- To investigate the prevalence, pattern, and severity of coronary artery disease (CAD) in patients with clinically significant peripheral artery disease (PAD) of the lower limbs.
- To determine the association between PAD location and the extent of CAD.
- To highlight the importance of screening for CAD in PAD patients.
Main Methods:
- A cross-sectional study involving 58 patients with diagnosed PAD undergoing angiographic evaluation.
- Selective coronary angiography (CAG) performed concurrently with peripheral arteriography.
- Data collected according to ACC/AHA guidelines for CAG.
Main Results:
- High prevalence of CAD was observed across different coronary arteries (LAD, LCX, RCA, LM).
- The proportion of CAD varied depending on the location of PAD lesions (aorto-iliac, femoro-popliteal, tibioperoneal).
- Patients with PAD but no CAD symptoms showed significant coronary artery involvement.
Conclusions:
- PAD patients frequently have previously unrecognized CAD.
- The pattern of PAD can indicate the severity of coronary artery involvement.
- Coronary angiography is crucial for detecting undiagnosed CAD in PAD patients, enabling timely management.
Abstract:
The purpose of this study was to investigate magnitude, pattern and involvement of previously unheralded coronary artery disease in patients suffering from clinically significant peripheral artery disease of lower limbs. This cross sectional study was carried out in National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from January 2014 to February 2015. Total 58 patients with clinically diagnosed peripheral arterial disease of lower limb undergoing angiographic evaluation. Selective CAG in addition to peripheral arteriography was performed in all the study population as per ACC/AHA guidelines for CAG (class IIa recommendation).In this study, it was documented that the proportion of coronary arterial disease was highest in LAD (63.9%) followed by LCX (55.6%), RCA (52.8%), and lowest LM (11.1%) in lesion with aorto-iliac segment. But the proportion of coronary arterial disease was highest in LCX (41.9%) followed by LAD (38.7%), RCA (35.5%), and lowest LM (12.9%) in lesion with femero-popliteal blood vessels. Similarly, the proportion of coronary arterial disease was highest in LCX (36.4%) followed by RCA (27.3%) and equal percentage in LAD and lowest in LM (9.1%) in tibioperoneal segment. Patients of peripheral arterial disease (PAD) having no symptoms of coronary artery disease (CAD) are more likely to have severe coronary artery involvement. Coronary angiogram should be done in patient with PAD to detect previously undetected CAD and pattern of PAD reflects the severity and involvement of coronary arteries.
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:30Peripheral Artery Disease I: Introduction
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease IV: Preventive Measures