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Peripheral artery disease in patients with coronary artery disease
B Atmer1, T Jogestrand, J Laska
1Department of Clinical Physiology, Huddinge University Hospital, Sweden.
Insights
Peripheral artery disease (PAD) affects 22% of patients with coronary artery disease. Early non-invasive PAD screening, like toe pressure measurement, is recommended for patients with suspected coronary heart disease.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Coronary artery disease (CAD) and peripheral artery disease (PAD) often coexist.
- Prevalence of PAD varies based on diagnostic methods and definitions.
- Non-invasive assessment of lower limb arterial abnormalities is crucial in patients with CAD.
Purpose of the Study:
- To determine the prevalence of PAD in patients with CAD.
- To investigate the relationship between the severity of CAD and PAD.
- To evaluate the utility of non-invasive methods for PAD detection.
Main Methods:
- Utilized digital volume pulse plethysmography and ankle/toe blood pressure measurements.
- Assessed 58 patients (49 males, 9 females; age 37-72) undergoing coronary angiography.
- Coronary artery disease severity was categorized into minimal, moderate, and marked lesions.
Main Results:
- Prevalence of PAD was 22% in the study cohort.
- PAD prevalence increased with CAD severity: 14% (minimal), 18% (moderate), and 32% (marked).
- A trend indicated higher PAD prevalence with more advanced coronary atherosclerosis.
Conclusions:
- Non-invasive peripheral arterial circulation investigation should be an early clinical consideration for patients with suspected coronary heart disease.
- Toe pressure measurement is a simple and effective technique for PAD assessment.
- Early detection of PAD in CAD patients can inform clinical management strategies.
Abstract:
The prevalence of peripheral vascular disease in patients with coronary artery disease has been investigated in many different ways and depends on the diagnostic methods and the definition of the atherosclerotic manifestations in the different vascular beds. In this study we used the non-invasive methods digital volume pulse plethysmography and ankle and toe blood pressure measurements to identify arterial abnormalities in the lower limbs in 58 patients (49 males and 9 females; age 37-72 years) examined with coronary angiography. The prevalence of peripheral artery disease was 22%, in agreement with the results of most previous investigations. There was a tendency towards increasing prevalence of peripheral artery disease with more advanced coronary artery disease: 14% of the patients with no or minimal coronary atheromotous lesions, 18% of the patients with moderate coronary atheromotous lesions and 32% of the patients with marked coronary atheromotous disease. For this reason a non-invasive investigation of the peripheral arterial circulation should be included early in the clinical consideration of patients with chest pain or similar symptoms suggesting coronary heart disease. Toe pressure measurement appears to be the most appropriate technique being rather simple in management and also in evaluation of results.