Abstract
Introduction. The rates of atherosclerotic disease as well as its multifocal aspects have been increasing significantly. It is important to know these associations to ensure comprehensive management of this category of patients. Aim. To estimate the frequency of the principal peripheral atherosclerotic associations in patients with coronary artery disease referred to cardiology in the University Hospital of Constantine. Methods. Our study is descriptive, cross-sectional, and mono-centric carried out in the unit of cardiovascular investigations of the Regional Military University Hospital of Constantine. The included patients had at least one significant coronary lesion ≥50 in a principal coronary artery. All our patients underwent an ultrasound evaluation (supra-aortic trunk echo-Doppler, Doppler Ultrasound of the aorta and lower limbs). Data were processed using SPSS Statistics V22. Results. The frequency of the association of Peripheral Artery Disease and Coronary Artery Disease was 34.7% representing the most frequent association. A hemodynamic carotid lesion (≥ 50%) and Abdominal Aortic Aneurysm were associated respectively with Coronary Artery Disease in 12% and 4.6% of patients in the current study. The triple association of coronary artery disease, Abdominal Aortic Aneurysm, and hemodynamic carotid disease was observed in 2.67%, whereas the triple association of Peripheral Artery Disease, coronary artery disease, and carotid stenosis≥50% was observed in 6.67%. The frequency of the association of coronary artery disease, Peripheral Artery Disease, and Abdominal Aortic Aneurysm was estimated at 3, 66%. The therapeutic strategy for multi-focal atherosclerotic disease is still discussed, but coronary artery disease dominates the prognosis. Conclusion. Carrying out a comprehensive assessment of patients with coronary artery disease helps significantly in establishing an adapted and pertinent management with an acceptable BenefitCost Ratio. Keywords: coronary artery disease; peripheral atheromatous disease; pan-vascular therapy.
Highlights
The rates of atherosclerotic disease as well as its multifocal aspects have been increasing significantly
The triple association of coronary artery disease, Abdominal Aortic Aneurysm and hemodynamic carotid disease was observed in 2.67%, whereas the triple association of Peripheral Artery Disease, coronary artery disease, and carotid stenosis≥50% was observed in 6.67%
For each region, we noticed the presence or not of a hemodynamic lesion ≥ 50% based on the velocimetric criteria (measurement of the peak systolic velocity (PSV) and the pulsed wave Doppler velocity ratios, at the site of the stenosis and upstream); at the iliac stage, for a stenosis ≥50%, a PSV> 200250 cm / s, and a PSV ratio> 2-2.5; at the subinguinal level, a ratio greater than 2.5 to 3 is generally accepted to differentiate stenosis and stricture of more than 50% [3]
Summary
Le profil systémique de la maladie athéromateuse augmente, en conséquence, les possibilités d’une atteinte multi focale, ces associations sont importantes à connaitre, afin d’assurer une prise en charge complète de cette catégorie de patients. Our mono-centric epidemiological study is descriptive, analytical supervised on a sample of 300 recognized and consecutive patients with CAD, at the cardiology department of the University Hospital of Constantine These patients had at least one lesion ≥ 50% on a main coronary artery; in spite of their age and sex, excluding those who refused to participate in this study, informed consent and patient engagement for this study are required, respecting anonymity. The echo-Doppler is said to be pathological, if at least one atheromatous plaque and / or a hemodynamic lesion has been existent, on one of the carotid axes (common carotid artery, internal carotid artery, external carotid artery), if this is not the case, we make use of the carotid intima-media thickness (IMT) ≥ 1mm [4]. Results are presented and awarded with 95% confidence intervals, as mean, median, standard deviation, and minimum and maximum values, for the quantitative variables and as a percentage with their standard deviation for categorical variables
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