Document Detail

Prevalence of coronary heart disease in patients with aortic aneurysm and/or peripheral artery disease.
MedLine Citation:
PMID:  19406262     Owner:  NLM     Status:  MEDLINE    
Although the presence of coronary heart disease (CHD) was the major determinant of perioperative mortality and long-term prognosis in patients with aortic aneurysm (AA) and peripheral artery disease (PAD), the prevalence and severity of CHD in patients with individual vascular diseases was unknown. Adenosine triphosphate-loading myocardial single-photon emission computed tomography therefore was performed in 788 patients with vascular diseases of the aorta and peripheral arteries, with AA in 500, PAD localized in the lower-limb arteries in 183, and combined AA and PAD in 105. Patients with known CHD, such as those with previous myocardial infarction or revascularization procedures, were excluded. Myocardial single-photon emission computed tomography was analyzed using a 20-segment model, and summed stress scores and summed difference scores were calculated. Stress-induced myocardial ischemia was defined as a summed difference score >or=2. The presence of myocardial ischemia was highest in patients with combined PAD and AA (73%), followed by PAD (55%; p = 0.005), and the lowest in patients with AA (37%; p <0.0001). Summed stress score was also the highest in patients with combined PAD and AA (11.6 +/- 9.9), followed by PAD (7.8 +/- 8.8; p <0.0001), and the lowest in patients with AA (4.0 +/- 6.2; p <0.0001 for both). Similarly, summed difference score was the highest in patients with combined PAD and AA (6.4 +/- 6.1), followed by PAD (4.4 +/- 5.7; p = 0.001) and AA (2.3 +/- 4.0; p <0.0001 for both). In conclusion, the prevalence of CHD in patients with PAD was >50%, and although myocardial ischemia was observed in only (1/3) of patients with AA, its prevalence not only doubled, but also indicated extensive myocardial ischemia when combined with PAD. Thus, cardiac evaluation was particularly important in patients with combined AA and PAD.
Kenichi Hirose; Taishiro Chikamori; Satoshi Hida; Hirokazu Tanaka; Yuko Igarashi; Yoshiko Watanabe; Nobusato Koizumi; Satoshi Kawaguchi; Yukio Obitsu; Hiroshi Shigematsu; Akira Yamashina
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  103     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-01     Completed Date:  2009-06-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1215-20     Citation Subset:  AIM; IM    
Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
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MeSH Terms
Age Distribution
Aged, 80 and over
Analysis of Variance
Aortic Aneurysm, Thoracic / diagnosis,  epidemiology*
Chi-Square Distribution
Cohort Studies
Coronary Angiography / methods*
Coronary Disease / diagnosis,  epidemiology*
Follow-Up Studies
Middle Aged
Peripheral Vascular Diseases / diagnosis,  epidemiology*
Retrospective Studies
Severity of Illness Index
Sex Distribution
Statistics, Nonparametric
Survival Analysis
Time Factors
Tomography, Emission-Computed, Single-Photon / methods*

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