Abstract 12813: Assessment of Coronary Artery Disease Severity and Prognostic Factors for Cardiovascular Events in Patients With Lower Limb Artery Disease

Abstract

Introduction: Cardiovascular mortality in patients with lower limb artery disease is higher in critical limb ischemia (CLI) than in intermittent claudication (IC). We sought to evaluate differential characteristics of coronary artery disease severity and prognostic factors for cardiovascular events between CLI and IC patients. Methods: Coronary and lower limb angiography was performed on 242 patients (age 73±8 years, mean±sd, men 186) without cardiac symptoms and with symptoms of either CLI or IC. From the coronary angiogram of each study patient, Gensini Score as an index of coronary angiographic severity and an incidence of significant stenosis (AHA classification, ≥75% stenosis) in at least one of major coronary arteries were evaluated. High sensitivity troponin T (hs-TnT), eicosapentaenoic acid-arachidonic acid ratio (EPA/AA), and lipoprotein (a), as biomarkers for prognostic factors, were measured from blood samples at rest in the fasting state. Results: The study patients were divided into CLI-group (42 patients) and IC-group (200 patients). Coronary angiography showed that Gensini Score and an incidence of significant stenosis (AHA classification, ≥75% stenosis) in at least one of major coronary arteries were higher in the CLI-group than in the IC-group (39±32 vs 8±8, p<0.001, 59.5% vs 22.0%, p<0.001, respectively). Hs-TnT and lipoprotein (a) values were higher in the CLI-group than the IC-group (0.15±0.19 ng/ml vs 0.05±0.09, p<0.001, 45.9±23.3 mg/dl vs 26.2±27.7, p<0.001, respectively) and EPA/AA was lower in the CLI-group than in the IC-group (0.22±0.11 vs 0.38±0.29, p<0.005, respectively). Conclusions: Greater coronary artery disease severity, higher hs-TnT and lipoprotein (a), and lower EPA/AA were observed in the CLI patients, which may explain higher cardiovascular events in CLI patients than IC.