Document Detail


Polyvascular extracoronary atherosclerotic disease in patients with coronary artery disease.
MedLine Citation:
PMID:  19784902     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiovascular diseases are the number one killer in the developed countries, accounting for approximately half of all deaths, with the leading causes being myocardial infarction and ischaemic stroke. In line with the ageing population, the prevalence of coronary artery disease (CAD), lower extremity peripheral arterial disease (PAD), supra-aortic arterial disease (SAD) and renal stenosis (RAS) is increasing. Polyvascular atherosclerosis (PVA) coexisting in several territories has an adverse effect on cardiovascular morbidity and mortality. AIM: To determine prevalence, coexistence and predictors of significant PAD, SAD and RAS in patients with suspected CAD. METHODS: Based on angiography, the frequency of coexisting CAD, SAD, PAD and RAS (stenosis > or =50%) was determined in 687 (487 male) consecutive patients, aged 63.5 +/- 9.1 years, referred for coronary angiography. RESULTS: Significant CAD was found in 545 (79.3%) patients (1-vessel in 164; 2-vessel in 157; 3-vessel in 224). SAD, RAS and PAD were found in 136 (19.8%), 55 (8%), and 103 (15%) patients, respectively. Of the 545 patients with confirmed CAD, 346 (63.5%) had stenoses limited to coronary arteries. 2-, 3- and 4-level PVA was found in 130 (23.8%), 61 (11.2%) and 8 (1.5%) patients, respectively. Of the 142 patients without CAD, 127 (89.4%) had no significant stenoses elsewhere, 12 (8.5%) had 1 extracoronary territory and 3 (2.1%) had 2-territory involvement. Backward stepwise binary logistic regression analysis showed the following independent predictors of at least 2-level PVA: 2- and 3-vessel CAD (p < 0.001), hyperlipidaemia (p = 0.067), smoking (p < 0.001), creatinine level > or = 1.3 ml/dl (p < 0.001), lower extremities claudication (p < 0.001) and female gender (p = 0.003). The relative risk of having at least 2-territory PVA was 15.7-fold higher in patients with claudication, 2.1-fold in patients with multivessel CAD, 2.8-fold for serum creatinine level > 1.3 mg/dl; and 1.9-fold, 2.4-fold and 2-fold in patients with hyperlipidaemia, smokers and women, respectively. Conclusions: Significant atherosclerosis in extracoronary arterial territories is present in 36% of patients with documented CAD. With advancing PVA, accumulation of atherosclerosis risk factors, previous atherothrombotic events and more severe CAD is observed.
Authors:
Tadeusz Przewłocki; Anna Kabłak-Ziembicka; Artur Kozanecki; Daniel Rzeźnik; Piotr Pieniazek; Piotr Musiałek; Adam Piskorz; Andrzej Sokołowski; Agnieszka Rosławiecka; Wiesława Tracz
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  67     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-12-29     Completed Date:  2010-07-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  978-84     Citation Subset:  IM    
Affiliation:
Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Collegium Medicum, The John Paul II Hospital, Krakow, Poland. tadeuszprzewlocki@op.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aortic Stenosis, Supravalvular / diagnosis,  epidemiology*
Comorbidity
Coronary Angiography
Coronary Artery Disease / diagnosis,  epidemiology*
Female
Humans
Hypertension, Renal / epidemiology
Intermittent Claudication / epidemiology
Logistic Models
Male
Middle Aged
Peripheral Vascular Diseases / diagnosis,  epidemiology*
Poland / epidemiology
Prevalence
Renal Artery Obstruction / epidemiology*
Risk Assessment
Severity of Illness Index*
Smoking / epidemiology

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