open access

Vol 67, No 8 (2009)
Other
Published online: 2009-09-09
Submitted: 2012-12-28
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Original article
Polyvascular extracoronary atherosclerotic disease in patients with coronary artery disease

Tadeusz Przewłocki, Anna Kabłak-Ziembicka, Artur Kozanecki, Daniel Rzeźnik, Piotr Pieniążek, Piotr Musiałek, Adam Piskorz, Andrzej Sokołowski, Agnieszka Rosławiecka, Wiesława Tracz
Kardiol Pol 2009;67(8):978-984.

open access

Vol 67, No 8 (2009)
Other
Published online: 2009-09-09
Submitted: 2012-12-28

Abstract


Background: Cardiovascular diseases are the number one killer in the developed countries, accounting for approximately half of all deaths, with the leading causes being myocardial infarction and ischaemic stroke. In line with the ageing population, the prevalence of coronary artery disease (CAD), lower extremity peripheral arterial disease (PAD), supra-aortic arterial disease (SAD) and renal stenosis (RAS) is increasing. Polyvascular atherosclerosis (PVA) coexisting in several territories has an adverse effect on cardiovascular morbidity and mortality.
Aim: To determine prevalence, coexistence and predictors of significant PAD, SAD and RAS in patients with suspected CAD.
Methods: Based on angiography, the frequency of coexisting CAD, SAD, PAD and RAS (stenosis ł 50%) was determined in 687 (487 male) consecutive patients, aged 63.5 ± 9.1 years, referred for coronary angiography.
Results: Significant CAD was found in 545 (79.3%) patients (1-vessel in 164; 2-vessel in 157; 3-vessel in 224). SAD, RAS and PAD were found in 136 (19.8%), 55 (8%), and 103 (15%) patients, respectively. Of the 545 patients with confirmed CAD, 346 (63.5%) had stenoses limited to coronary arteries. 2-, 3- and 4-level PVA was found in 130 (23.8%), 61 (11.2%) and 8 (1.5%) patients, respectively. Of the 142 patients without CAD, 127 (89.4%) had no significant stenoses elsewhere, 12 (8.5%) had 1 extracoronary territory and 3 (2.1%) had 2-territory involvement. Backward stepwise binary logistic regression analysis showed the following independent predictors of at least 2-level PVA: 2- and 3-vessel CAD (p < 0.001), hyperlipidaemia (p = 0.067), smoking (p < 0.001), creatinine level ł 1.3 ml/dl (p < 0.001), lower extremities claudication (p < 0.001) and female gender (p = 0.003). The relative risk of having at least 2-territory PVA was 15.7-fold higher in patients with claudication, 2.1-fold in patients with multivessel CAD, 2.8-fold for serum creatinine level > 1.3 mg/dl; and 1.9-fold, 2.4-fold and 2-fold in patients with hyperlipidaemia, smokers and women, respectively.
Conclusions: Significant atherosclerosis in extracoronary arterial territories is present in 36% of patients with documented CAD. With advancing PVA, accumulation of atherosclerosis risk factors, previous atherothrombotic events and more severe CAD is observed.

Abstract


Background: Cardiovascular diseases are the number one killer in the developed countries, accounting for approximately half of all deaths, with the leading causes being myocardial infarction and ischaemic stroke. In line with the ageing population, the prevalence of coronary artery disease (CAD), lower extremity peripheral arterial disease (PAD), supra-aortic arterial disease (SAD) and renal stenosis (RAS) is increasing. Polyvascular atherosclerosis (PVA) coexisting in several territories has an adverse effect on cardiovascular morbidity and mortality.
Aim: To determine prevalence, coexistence and predictors of significant PAD, SAD and RAS in patients with suspected CAD.
Methods: Based on angiography, the frequency of coexisting CAD, SAD, PAD and RAS (stenosis ł 50%) was determined in 687 (487 male) consecutive patients, aged 63.5 ± 9.1 years, referred for coronary angiography.
Results: Significant CAD was found in 545 (79.3%) patients (1-vessel in 164; 2-vessel in 157; 3-vessel in 224). SAD, RAS and PAD were found in 136 (19.8%), 55 (8%), and 103 (15%) patients, respectively. Of the 545 patients with confirmed CAD, 346 (63.5%) had stenoses limited to coronary arteries. 2-, 3- and 4-level PVA was found in 130 (23.8%), 61 (11.2%) and 8 (1.5%) patients, respectively. Of the 142 patients without CAD, 127 (89.4%) had no significant stenoses elsewhere, 12 (8.5%) had 1 extracoronary territory and 3 (2.1%) had 2-territory involvement. Backward stepwise binary logistic regression analysis showed the following independent predictors of at least 2-level PVA: 2- and 3-vessel CAD (p < 0.001), hyperlipidaemia (p = 0.067), smoking (p < 0.001), creatinine level ł 1.3 ml/dl (p < 0.001), lower extremities claudication (p < 0.001) and female gender (p = 0.003). The relative risk of having at least 2-territory PVA was 15.7-fold higher in patients with claudication, 2.1-fold in patients with multivessel CAD, 2.8-fold for serum creatinine level > 1.3 mg/dl; and 1.9-fold, 2.4-fold and 2-fold in patients with hyperlipidaemia, smokers and women, respectively.
Conclusions: Significant atherosclerosis in extracoronary arterial territories is present in 36% of patients with documented CAD. With advancing PVA, accumulation of atherosclerosis risk factors, previous atherothrombotic events and more severe CAD is observed.
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Keywords

artery disease; prevalence of polyvascular extracoronary stenoses; angiography; predictors

About this article
Title

Original article
Polyvascular extracoronary atherosclerotic disease in patients with coronary artery disease

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 67, No 8 (2009)

Pages

978-984

Published online

2009-09-09

Bibliographic record

Kardiol Pol 2009;67(8):978-984.

Keywords

artery disease
prevalence of polyvascular extracoronary stenoses
angiography
predictors

Authors

Tadeusz Przewłocki
Anna Kabłak-Ziembicka
Artur Kozanecki
Daniel Rzeźnik
Piotr Pieniążek
Piotr Musiałek
Adam Piskorz
Andrzej Sokołowski
Agnieszka Rosławiecka
Wiesława Tracz

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