Document Detail

Prevalence and prediction of previously unrecognized peripheral arterial disease in patients with coronary artery disease: the Peripheral Arterial Disease in Interventional Patients Study.
MedLine Citation:
PMID:  19213068     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. OBJECTIVE: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiography and/or intervention and to determine the relationship between presence of PAD and severity of CAD. METHODS: The Peripheral Arterial Disease in Interventional Patients Study (PIPS) is a prospective cohort study conducted at an inpatient service of a tertiary referral center. A total of 800 patients referred for coronary angiography without prior diagnosis of PAD aged 70 years or older or aged 50-69 years with a history of tobacco use and/or diabetes mellitus were included. Evaluation involved a medical history, a questionnaire to assess symptoms and functional status, and measurement of the ankle-brachial index (ABI). PAD was considered present if the ABI was 0.90 or less. RESULTS: The prevalence of previously unrecognized PAD was 15%, 95% CI (12.6-17.7) and was highest among patients over 70 years of age (25.2%) and in women (23.3%). Among patients with CAD, those with PAD had higher prevalence of left main and multivessel coronary artery disease (87.2% vs. 75.5%, P = 0.006). Alternatively, patients with multivessel CAD had a twofold higher risk of being diagnosed with previously unrecognized PAD compared with those with single vessel CAD [adjusted OR = 2.02, (95% CI 1.03-3.98)]. CONCLUSIONS: PAD is often overlooked even in patients with known ischemic heart disease under specialist cardiovascular care. Overlooked PAD in this population increases in frequency with advanced age, in women, and in the presence of other traditional cardiovascular risk factors. Furthermore, the presence of PAD in this population identifies a subgroup with more severe form of CAD.
Issam D Moussa; Michael R Jaff; Roxana Mehran; William Gray; George Dangas; Zoran Lazic; Jeffery W Moses
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  73     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-22     Completed Date:  2009-06-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  719-24     Citation Subset:  IM    
Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medical Center, Weill Medical College of Cornell University, New York, New York, USA.
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MeSH Terms
Age Factors
Angioplasty, Transluminal, Percutaneous Coronary*
Ankle / blood supply
Blood Pressure
Brachial Artery / physiopathology
Coronary Angiography*
Coronary Artery Disease / complications,  epidemiology,  radiography*,  therapy*
Intermittent Claudication / etiology
Middle Aged
Odds Ratio
Peripheral Vascular Diseases / complications*,  diagnosis,  epidemiology,  physiopathology
Prospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Sex Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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