Abstract 15184: Prevalence, Predictors and Clinical Outcomes of Unknown Coronary Artery Disease Among the Patients Undergoing Lower Extremity Endovascular Intervention

Abstract

Introduction: The prevalence and clinical outcomes of unknown coronary artery disease (CAD) among the patients with peripheral artery disease, particularly for those undergoing lower extremity endovascular intervention, were not well evaluated. Methods: Between 2006 and 2014, a total of 208 consecutive patients (73±10 years, 165 men) without angina and prior coronary revascularization, were underwent lower extremity endovascular intervention. All patients evaluated coronary angiography without simutaneous coronary revascularization. CAD was defined as angiographically significant (≥50%) stenosis. All-cause mortality and major adverse cardiac and cerebrovascular event (MACCE) rate were compared between the patients with CAD and those without CAD. MACCE included cardiac death, cerebrovascular death, myocardial infarction, stroke, or heart failure. Results: Of the 208 patients, 103 patients (50%) had CAD; 1-VD (17%); 2-VD (17%); 3-VD (15%). Independent predictors of CAD were critical limb ischemia (OR=2.4) and below-the-knee lesions (OR=2.0). During the median follow-up of 1.2 years, all-cause mortality and MACCE rate at 3 year were 16.3% and 19.8%. At 3 year, patients with CAD had significantly higher mortality (19% vs. 14%, P=0.018) and higher MACCE rate (28% vs. 9%, P=0.001) compared to those without CAD. The severity of CAD had graded relations with the mortality and MACCE rate (Figure). Presence of CAD was an independent predictor of mortality (HR=1.5, P=0.025) and MACCE rate (HR=1.9, P<0.001). Conclusions: Previously unknown CAD was detected in half of the patients undergoing lower extremity endovascular intervention and associated with higher mortality and MACCE rate. Detection of CAD might be important for risk stratification for these patients, especially with below-the-knee lesions.