Abstract
The presence of peripheral arterial occlusive disease increases the morbidity and mortality of patients with coronary artery disease. The objective of the present study was to calculate the prevalence of peripheral arterial occlusive disease in patients referred for coronary angiography. This prevalence study was carried out at the Hemodynamics Unit of Hospital Santa Isabel, Salvador, Brazil, from December 2004 to April 2005. After approval by the Ethics Committee of the hospital, 397 patients with angiographic signs of coronary artery disease were enrolled. Diagnosis of peripheral arterial occlusive disease was made using the ankle-brachial blood pressure index (< or =0.90). Statistical analyses were performed using the z test and a level of significance of alpha = 5%, 95%CI, the chi-square test and t-test, and multiple logistic regression analysis. The prevalence of peripheral arterial occlusive disease was 34.3% (95%CI: 29.4-38.9). Mean age was 65.7 +/- 9.4 years for patients with peripheral arterial occlusive disease, and 60.3 +/- 9.8 years for patients without peripheral arterial occlusive disease (P = 0.0000003). The prevalence of peripheral arterial occlusive disease was 1.57 times greater in patients with hypertension (P = 0.007) and 2.91 times greater in patients with coronary stenosis > or =50% (P = 0.002). Illiterate patients and those with little education had a 44% higher chance of presenting peripheral arterial occlusive disease probably as a result of public health prevention policies of limited effectiveness. The prevalence of peripheral arterial occlusive disease in patients referred to a tertiary care hospital in Salvador, Bahia, for coronary angiography, was 34.3%.
Highlights
Peripheral arterial occlusive disease (PAOD) in patients with coronary artery disease (CAD) compromises the recovery and postoperative quality of life of patients who undergo myocardial revascularization [1,2].Early identification of PAOD by vascular surgeons in patients with CAD is fundamental to reduce morbidity and mortality in this group of patients [1,3,4,5,6,7].Studies involving patients with CAD and PAOD have detected greater morbidity and mortality than among patients with only CAD
Several investigators have reported the effects of PAOD on the survival of patients with CAD, few studies in the literature have estimated the prevalence of PAOD in patients with CAD using the ankle-brachial blood pressure index (ABPI) [10]
The prevalence of PAOD in patients referred for coronary angiography and presenting CAD was 34.3% (136/397; 95% confidence interval (95%CI): 29.4-38.9)
Summary
Peripheral arterial occlusive disease (PAOD) in patients with coronary artery disease (CAD) compromises the recovery and postoperative quality of life of patients who undergo myocardial revascularization [1,2].Early identification of PAOD by vascular surgeons in patients with CAD is fundamental to reduce morbidity and mortality in this group of patients [1,3,4,5,6,7].Studies involving patients with CAD and PAOD have detected greater morbidity and mortality than among patients with only CAD. Peripheral arterial occlusive disease (PAOD) in patients with coronary artery disease (CAD) compromises the recovery and postoperative quality of life of patients who undergo myocardial revascularization [1,2]. Identification of PAOD by vascular surgeons in patients with CAD is fundamental to reduce morbidity and mortality in this group of patients [1,3,4,5,6,7]. Studies involving patients with CAD and PAOD have detected greater morbidity and mortality than among patients with only CAD. Patients with CAD and PAOD had a greater risk of cerebral vascular accidents after myocardial revascularization and a 25% increase in mortality [4,6,8,9]. The ethnic diversity and miscegenation of the Brazilian population require that epidemiological studies use high-quality diagnostic methods and include representative samples of the population to define the rate of high-risk patients and to promote early follow-up by vascular surgeons to prevent complications
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