Prevalence of Peripheral Arterial Disease in Patients With Coronary Artery Disease After Cardiac Catheterization: A Prospective Observational Study

Abstract

Peripheral arterial disease (PAD) is a common vascular condition with roughly one-half of patients being asymptomatic. Moreover, PAD is commonly seen in patients with coronary artery disease (CAD) due to their shared atherosclerotic pathway. Our aim was to understand the prevalence and symptomatology of PAD in patients with established CAD seen on coronary angiography. Subjects with CAD were prospectively screened for PAD at a single-site catheterization laboratory (June 2021-April 2022). Following consent, a bedside ankle-brachial-index (ABI) (Microlife WatchBP Office ABI) was performed, and the Edinburgh Claudication Questionnaire (ECQ) (validated for PAD) was administered. PAD was defined as an ABI ≤0.90.We recruited 100 subjects (98 completed investigations: 67.5 age ± 9.5 years, 17.3% female). Twenty-one subjects (21.4%) had PAD as demonstrated by an abnormal ABI or previous diagnosis. There was a strong trend towards a higher prevalence of diabetes in those with PAD (52.4% vs. 29.9%, p=0.055). Kappa agreement between ECQ and ABI was weak (0.27). In conclusion, roughly one-quarter of subjects with CAD had ABI confirmed PAD (even more common in diabetics). The ECQ provided low agreement with ABI suggesting many of these subjects are asymptomatic. ABI can be used as a simple non-invasive tool at the bedside following cardiac catheterization to screen for PAD which has implications on subsequent clinical care.