Prevalence of Peripheral Artery Disease and Its Association With Coronary Artery Disease in Patients Undergoing...

Background Peripheral artery disease (PAD) is an underrecognized manifestation of atherosclerotic cardiovascular disease compared with coronary artery disease (CAD) and cerebrovascular diseases despite sharing a common atherosclerotic pathogenesis and many of the risk factors. Although a coronary angiogram remains the gold standard for diagnosing CAD, its invasive nature limits its suitability as a screening tool. The ankle-brachial pressure index (ABPI) has been recognized as a reliable marker of peripheral arterial disease and generalized atherosclerosis; however, its utility in predicting CAD in patients undergoing a coronary angiogram requires further evaluation. Objective This study aimed to determine the prevalence of PAD by using the ABPI and to study the association of CAD in patients undergoing a coronary angiogram. Methodology This cross-sectional analytical study was conducted among 431 patients who underwent a coronary angiogram at the cardiology unit of the Teaching Hospital in Northern Sri Lanka from October 2022 to May 2023. Patients who consented to participate in the study were recruited consecutively until reached sample size. All collected data were entered into the Statistical Package for the Social Sciences (SPSS) software, version 30.0 (IBM Corp., Armonk, NY), and analyzed. Measurement of ABPI was performed to confirm the diagnosis of PAD. Results The majority of patients (74%) were male, and the mean age was 59.34 ± 10.19 years, with a range of 31 to 81 years. Prevalence of PAD in patients undergoing a coronary angiogram was 12.5% (95% CI: 9.6-15.9). Among 54 patients with PAD, 51 (94.4%) had CAD. This association is statistically significant (p=0.019). Patients with PAD have a 3.8 times higher risk (95% CI: 1.3-15.8) of having CAD. Specificity of PAD for predicting CAD (ABPI<0.9) was 95.8% (95% CI: 88.4%-98.6%), and sensitivity was 14.2% (95% CI: 11.0%-18.2%). Predictive value of positive test was 94.4% (95% CI: 85.5%-98.0%), and predictive value of negative test was 18.3% (95% CI: 17.3%-19.3%). The prevalence of PAD among multivessel disease (double and triple vessel) was higher (16.8%) than in those with single-vessel disease (14.2%), and this result is statistically significant (p=0.037). Conclusion The prevalence of PAD among the patients undergoing coronary artery angiograms in this study is 12.5%. The strong association between CAD and PAD is confirmed in our population, and prediction of CAD using PAD (ABPI<0.9) showed high specificity but low sensitivity. A severe form of CAD is likely in patients with PAD.