Abstract
Patients with peripheral artery disease are at high risk of coronary artery disease. An increasing number of studies show that a large proportion of patients with peripheral artery disease have significant coronary atherosclerosis, even in the absence of symptoms. Although the reported prevalence of subclinical coronary artery disease varies widely in patients with peripheral artery disease, it could include more than half of patients. No consensus exists to date on either the rationale for screening patients with peripheral artery disease for coronary atherosclerosis or the optimal algorithm and method for screening. An increasing number of imaging modalities are emerging that allow improved in vivo non-invasive characterization of atherosclerotic plaques. These novel imaging methods may lead to early detection of high-risk vulnerable plaques, enabling clinicians to improve risk stratification of patients with peripheral artery disease, and thus paving the way for individualized therapy.
Highlights
Atherosclerosis is a systemic degenerative inflammatory vascular disease and the primary underlying cause of coronary heart disease
Patients with peripheral artery diseases (PAD) are known to manifest atherosclerosis, and as endothelial dysfunction is an early hallmark of atherosclerosis, it should be expected that flow-mediated dilation would be attenuated in all patients with PAD
An already significant and ever-increasing body of evidence indicates a high prevalence of subclinical coronary atherosclerosis in patients with manifest PAD
Summary
Atherosclerosis is a systemic degenerative inflammatory vascular disease and the primary underlying cause of coronary heart disease. About half of all patients who die from coronary heart disease have no prior diagnosis or symptoms of cardiac disease [1]. Despite this fact, screening asymptomatic adults for cardiovascular risk by imaging is considered inappropriate in most cases by current guidelines [2]. In addition to the clinical risk scores, a number of medical conditions indicate a cardiovascular risk similar to that of patients with established coronary heart disease [3, 4]. These coronary heart disease risk equivalents are conditions such as diabetes and peripheral artery diseases (PAD), including lower limb arterial disease, abdominal aortic aneurism, and carotid artery disease.
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