Frequency of Peripheral Artery Disease in association with Coronary Artery Disease: a cross-sectional monocentric study in eastern Algeria

Rachid Merghit,Mouloud Ait Athmane,Abdelhak Lakehal

doi:10.48087/bjmsoa.2020.7202

Abstract

Introduction. Patients with both Coronary Artery Disease (CAD) and Peripheral Artery Disease (PAD) have a worse cardiovascular prognosis. It therefore seems interesting to detect this association, in particular by measuring the ankle-brachial systolic pressure index (ABI) which is a simple, inexpensive, and non-invasive way with a significant diagnostic input that can detect silent but threatening lesions. It can also identify a subgroup of patients with coronary artery disease at a higher cardiovascular risk requiring a more specific management. Aims. Estimate the frequency of peripheral artery disease (PAD) in patients with Coronary Artery Disease CAD who were recruited at the department of cardiology at the university hospital of Constantine. This the study also aims to detect the risk factors of this association. Patients and methods. Our study is descriptive, cross-sectional, single-centered in cardiovascular exploration units of the regional military university hospital of Constantine. The included subjects had at least one significant coronary lesion in a major coronary artery using radial Coronary angiography. Guided medical history and a cardiovascular clinical examination preceded the measurement of the ABI for each patient. PAD was defined by an ABI of less than 0.90 in one of the four distal arteries of the two lower limbs. Data were analyzed and processed by Epi-Info Statistics V7. Results. 300 coronary patients, the average age of 61 years, mostly males, took part in the study. The frequency of the combination of PAD and coronary artery disease was 34.7% using the ABI, asymptomatic in 18% of cases. independent factors of the association were : Age≥ 65 [aOR 3,67, P <0,0001], tobacco [aOR 4,10, P<0,002], diabetes [aOR 3,48, P<0,0001] , AHT [aOR 3,30, P<0,0001], dyslipidemia [aOR 2.32, P<0,009], inactivity [aOR 2,14, P<0,015] , stroke [aOR 6,4, P<0,015] and severe coronary impairment [aOR 2,36, P<0,015]. Conclusion. ABI, in addition to being an early detection tool for PAD, its dissemination in medical practice would help in the approach and refinement of vascular risk in coronary heart patients.

Highlights

Les coronariens ayant une atteinte vasculaire périphérique ont un pronostic cardiovasculaire plus sévère
The patients received a collection of anthropometric measurements, a collection of information, a comprehensive clinical examination, a biological balance including complete lipid profile (HDLC,Total cholesterol, triglyceride, LDL-C), fasting blood glucose, creatinine levels, calculated creatinine clearance according to the MDRD formula and HBA1C for diabetic patients. we measured the ankle-brachial systolic pressure index (ABI) in dorsal decubitus, the upper limbs undressed, in a patient relaxed for more than 10 minutes, by a pocket doppler (Sonotrax Vascular Lite, brand: EDAN), equipped with a probe of 8 MHz, with a sphygmomanometer
Diabetes was associated with arterial hypertension (AHT) and dyslipidemia in 36%, 47.3% of cases respectively; triple association was observed in 37.7%

Summary

Introduction

Les coronariens ayant une atteinte vasculaire périphérique ont un pronostic cardiovasculaire plus sévère. L’IPS, en plus d’être un outil de dépistage précoce de l’AOMI, sa diffusion en pratique médicale aiderait à l’approche et l’affinement du risque vasculaire des patients coronariens Patients with both Coronary Artery Disease (CAD) and Peripheral Artery Disease (PAD) have a worse cardiovascular prognosis. It seems interesting to detect this association, in particular by measuring the ankle-brachial systolic pressure index (ABI) which is a simple, inexpensive and non-invasive way with a significant diagnostic input that can detect silent but threatening lesions It can identify a subgroup of patients with coronary artery disease at a higher cardiovascular risk requiring a more specific management. Wanted by measurement of the ankle-brachial systolic pressure index (ABI) in coronary patients, the prevalence of peripheral arterial disease (PAD) can reach more than 30% according to the age of the subjects and can even exceed 40% in hospitalized subjects [3]. The lowest index of the two lower limbs was the one considered, making the diagnosis of PAD if lower or equal 0.9 in the presence or absence of symptomatology

Objectives

Results

Conclusion