Concomitant peripheral vascular and coronary artery disease: A new dimension for the global endovascular specialist?

Background: Early and accurate diagnosis of peripheral atherosclerosis is of paramount importance for global management of patients with known coronary artery disease (CAD). Hypothesis: We sought to evaluate retrospectively the prevalence and clinical relevance of significant abdominal vessel stenosis or aneurysm (AVA) in patients undergoing coronary angiography. Methods: Medical records of consecutive patients who underwent coronary angiography at two public institutions over a 12-month period were evaluated. Angiographic results of patients who underwent diagnostic abdominal aorta angiography, based on clinical criteria, to evaluate abdominal vessels at the same time as coronary angiography were analyzed. Results: During the study period, AVA was reported in 180 (35.7%) of 504 consecutive patients (335 men, mean age 68 +/- 13.8 years): renal artery stenosis was found in 13.1 % of cases (66 patients), aortoiliac artery disease in 13.7% (69 patients), and aortic aneurysmal disease in 8.9% (45 patients). Logistic regression analyses revealed >= 3-vessel CAD (odds ratio [OR] 9.917, p = 0.002), age > 65 years (OR 3.817, p = 0.036), >= 3 risk factors (OR 2.8, p = 0.048) as independent predictors of AVA. Conclusion: Multiple vascular atherosclerotic distributions are frequent in elderly patients who have multivessel CAD and a high-risk profile, suggesting the usefulness of a more global and comprehensive cardiovascular approach.