Document Detail


Supra-aortic extracranial artery atherosclerotic lesions in patients diagnosed for coronary artery disease: prevalence and predictors.
MedLine Citation:
PMID:  19784903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In patients with coronary artery disease (CAD), the presence of atherosclerotic lesions in other vascular beds is associated with a markedly worse prognosis. AIM: To determine the prevalence and predictors of extracranial supra-aortic artery atherosclerotic disease (SAD) in patients with suspected CAD. METHODS: Supra-aortic artery angiography was performed in 379 consecutive patients aged 64.2 +/- 8.8 years (231 male) referred for coronary angiography. Clinical and laboratory data (total cholesterol, LDL, HDL cholesterol, hs-CRP, creatinine level) and left ventricular ejection fraction were analysed. RESULTS: Significant stenosis (> or =50% by quantitative angiography) within at least one main branch of the coronary arteries was found in 314 (82.8%) patients, including 87 (27.7%), 96 (30.6%) and 131 (41.7%) with 1-vessel, 2-vessel, and 3-vessel CAD, respectively. Among all 379 patients, stenosis > or =50% of the carotid artery was documented in 9.5%, vertebral in 13.7%, and subclavian in 7.4% of patients. We found 130 stenoses > or =50% within the supra-aortic arteries in 90 patients (23.7% of the whole study group, and 28.7% of CAD patients), including 42 internal carotid artery stenoses in 36 patients, 58 vertebral artery stenoses in 52, and 30 subclavian stenoses in 28 patients. In 24 (6.3%) patients more than one SAD was present. The SAD > or =50% was found in 8 (12.3%) patients without significant CAD, in 22 (25.3%), 17 (17.7%) and 43 (32.8%) with 1-, 2- and 3-vessel CAD, respectively (p = 0.001). Independent predictors of SAD > or =50% identified by multivariate analysis were: previous neurological ischaemic event (p = 0.001), CAD (p = 0.015), creatinine level (p = 0.031), male gender (p = 0.001), claudication (p < 0.001) and low HDL cholesterol (p = 0.033). The following independent predictors of vertebral and/or subclavian artery stenosis > 50% were identified: CAD severity (p = 0.002), creatinine level (p = 0.024), male gender (p = 0.013), claudication (p < 0.001) and low HDL cholesterol level (p = 0.059). CONCLUSIONS: In a large patient sample, we have found that significant supra-aortic atherosclerosis is present in a quater of patients with suspected CAD. Importantly, SAD prevalence increases with CAD severity. Previous neurological ischaemic event, CAD, creatinine level, male gender, claudication and hyperlipidaemia were identified as independent predictors of SAD > or =50%.
Authors:
Tadeusz Przewłocki; Anna Kabłak-Ziembicka; Artur Kozanecki; Piotr Musiałek; Adam Piskorz; Daniel Rzeźnik; Piotr Pieniazek; Paweł Rubiś; Wiesława Tracz
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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:  985-91     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
Age Distribution
Aged
Aortic Stenosis, Supravalvular / diagnosis*,  epidemiology*
Comorbidity
Coronary Angiography
Coronary Artery Disease / diagnosis*,  epidemiology*
Creatinine / blood
Female
Humans
Hyperlipidemias / epidemiology
Intermittent Claudication / epidemiology
Male
Middle Aged
Poland / epidemiology
Prevalence
Risk Assessment
Severity of Illness Index*
Sex Distribution
Smoking / epidemiology
Chemical
Reg. No./Substance:
60-27-5/Creatinine

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