The Prevalence Of Peripheral Arterial Disease In Patients Referred For Cardiac Nuclear Stress Testing

Abstract

PURPOSE It has been demonstrated that patients with coronary artery disease (CAD) have a higher prevalence of peripheral arterial disease (PAD). This study was designed to determine the prevalence of PAD in patients with suspected CAD referred for non-invasive cardiac testing. METHODS This is an ongoing prospective registry of consecutive patients with suspected CAD referred for exercise stress thallium (EST) or adenosine stress thallium (AST) testing, without a previous diagnosis of PAD. Each patient had an Ankle-Brachial index (ABI) measured prior to the nuclear stress test. An ABI of <0.9 was used to diagnose PAD. RESULTS A total of 177 patients (60% males) were enrolled, mean age 66 +/− 12.6 years. 120 pts had EST; 57 pts had AST. Overall, coronary ischemia was diagnosed in 42/177 pts (24%). PAD was diagnosed in 27/177 patients, giving an over-all prevalence of 15%; the prevalence of PAD was significantly higher in pts referred for adenosine stress testing compared to exercise stress testing (25% vs. 11 %, p=0.03). A comparison between patients with and without PAD is shown in the table below.TableCONCLUSION PAD is an important problem that is under diagnosed and consequently under treated. In patients referred for non-invasive testing for cardiac ischemia, the PAD group was more likely to have CAD or risk factors for atherosclerosis. More widespread use of the ABI to detect PAD in higher risk populations may be useful for optimization of medical therapy.