Abstract

IntroductionFunctional changes in peripheral arterial disease (PAD) could play a role in higher cardiovascular risk in these patients.Methods123 patients who underwent elective coronary angiography were included. Ankle-brachial index (ABI) was measured and arterial stiffness parameters were derived with applanation tonometry.Results6 patients (4.9%) had a previously known PAD (Rutherford grade I). Mean ABI was 1.04 ± 0.12, mean subendocardial viability ratio (SEVR) 166.6 ± 32.7% and mean carotid-femoral pulse wave velocity (cfPWV) 10.3 ± 2.4 m/s. Most of the patients (n = 81, 65.9%) had coronary artery disease (CAD). There was no difference in ABI among different degrees of CAD. Patients with zero- and three-vessel CAD had significantly lower values of SEVR, compared to patients with one- and two-vessel CAD (159.5 ± 32.9%/158.1 ± 31.5% vs 181.0 ± 35.2%/166.8 ± 27.8%; p = 0.048). No significant difference was observed in cfPWV values. Spearman's correlation test showed an important correlation between ABI and SEVR (r = 0.196; p = 0.037) and between ABI and cfPWV (r = − 0.320; p ≤ 0.001). Multiple regression analysis confirmed an association between cfPWV and ABI (β = − 0.210; p = 0.003), cfPWV and mean arterial pressure (β = 0.064; p < 0.001), cfPWV and age (β = 0.113; p < 0.001) and between cfPWV and body mass index (BMI (β = − 0.195; p = 0.028), but not with arterial hypertension, dyslipidemia, diabetes mellitus or smoking status. SEVR was not statistically significantly associated with ABI using the same multiple regression model.ConclusionReduced ABI was associated with increased cfPWV, but not with advanced CAD or decreased SEVR.

Highlights

  • Functional changes in peripheral arterial disease (PAD) could play a role in higher cardiovascular risk in these patients

  • None of the included patients were on the renal replacement therapy with hemodialysis or peritoneal dialysis or had a history of kidney transplantation

  • The association between Ankle-brachial index (ABI) and carotid-femoral pulse wave velocity (cfPWV) is present even when confounded for several traditional atherosclerosis risk factors

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Summary

Introduction

Functional changes in peripheral arterial disease (PAD) could play a role in higher cardiovascular risk in these patients. Atherosclerosis is a chronic inflammatory vascular disease, characterized by progressive plaque build-up in the vessel wall, leading to tissue ischemia [1, 2]. It is correlated with different forms of cardiovascular disease (CVD), such as coronary artery disease (CAD), Traditional risk factors for atherosclerosis and CVD include genetic predisposition, arterial hypertension, dyslipidemia, diabetes mellitus, metabolic syndrome, smoking, a diet rich in fats and psychological stress [6]. In Europe, it is estimated that 5.3% or nearly 40 million people have PAD [13]

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