scholarly journals Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251542
Author(s):  
Byoung Geol Choi ◽  
Ji-Yeon Hong ◽  
Seung-Woon Rha ◽  
Cheol Ung Choi ◽  
Michael S. Lee
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Significant Coronary Artery Disease ◽  
Arterial Disease ◽  
Term Survival ◽  
Artery Disease ◽  
Peripheral Arterial

Background Patients with peripheral arterial disease (PAD) have known to a high risk of cardiac mortality. However, the effectiveness of the routine evaluation of coronary arteries such as routine coronary angiography (CAG) in PAD patients receiving percutaneous transluminal angioplasty (PTA) is unclear. Methods A total of 765 consecutive PAD patients underwent successful PTA and 674 patients (88.1%) underwent routine CAG. Coronary artery disease (CAD) was defined as angiographic stenosis ≥70%. Patients were divided into three groups; 1) routine CAG and a presence of CAD (n = 413 patients), 2) routine CAG and no CAD group (n = 261 patients), and 3) no CAG group (n = 91 patients). To adjust for any potential confounders that could cause bias, multivariable Cox-proportional hazards regression and propensity score matching (PSM) analysis was performed. Clinical outcomes were evaluated by Kaplan-Meier curved analysis at 5-year follow-up. Results In this study, the 5-year survival rate of patients with PAD who underwent PTA was 88.5%. Survival rates were similar among the CAD group, the no CAD group, and the no CAG group, respectively (87.7% vs. 90.4% vs. 86.8% P = 0.241). After PSM analysis between the CAD group and the no CAD group, during the 5-year clinical follow-up, there were no differences in the incidence of death, myocardial infarction, strokes, peripheral revascularization, or target extremity surgeries between the two groups except for repeat PCI, which was higher in the CAD group than the non-CAD group (9.3% vs. 0.8%, P<0.001). Conclusion PAD patients with CAD were expected to have very poor long-term survival, but they are shown no different long-term prognosis such as mortality compared to PAD patients without CAD. These PAD patients with CAD had received PCI and/or optimal medication treatment after the CAG. Therefore a strategy of routine CAG and subsequent PCI, if required, appears to be a reasonable strategy for mortality risk reduction of PAD patients. Our results highlight the importance for evaluation for CAD in patients with PAD.

Anemia increases long-term mortality in patients undergoing conventional coronary angiography – the ECAT registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Balcer ◽  
I Dykun ◽  
S Hendricks ◽  
F Al-Rashid ◽  
M Totzeck ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Regression Analysis ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Conventional Coronary Angiography ◽  
Term Survival ◽  
Coronary Syndrome ◽  
Artery Disease

Abstract Background Anemia is a frequent comorbidity in patients with coronary artery disease (CAD). Besides a complemental effect on myocardial oxygen undersupply of CAD and anemia, available data suggests that it may independently impact the prognosis in CAD patients. We aimed to determine the association of anemia with long-term survival in a longitudinal registry of patients undergoing conventional coronary angiography. Methods The present analysis is based on the ECAD registry of patients undergoing conventional coronary angiography at the Department of Cardiology and Vascular Medicine at the University Clinic Essen between 2004 and 2019. For this analysis, we excluded all patients with missing hemoglobin levels at baseline admission or missing follow-up information. Anemia was defined as a hemoglobin level of &lt;13.0g/dl for male and &lt;12.0g/dl for female patients according to the world health organization's definition. Cox regression analysis was used to determine the association of anemia with morality, stratifying by clinical presentation of patients. Hazard ratio and 95% confidence interval are depicted for presence vs. absence of anemia. Results Overall, data from 28,917 patient admissions (mean age: 65.3±13.2 years, 69% male) were included in our analysis (22,570 patients without and 6,347 patients with anemia). Prevalence of anemia increased by age group (age &lt;50 years: 16.0%, age ≥80 years: 27.7%). During a mean follow-up of 3.2±3.4 years, 4,792 deaths of any cause occurred (16.6%). In patients with anemia, mortality was relevantly higher as compared to patients without anemia (13.4% vs. 28.0% for patients without and with anemia, respectively, p&lt;0.0001, figure 1). In univariate regression analysis, anemia was associated with 2.4-fold increased mortality risk (2.27–2.55, p&lt;0.0001). Effect sizes remained stable upon adjustment for traditional risk factors (2.38 [2.18–2.61], p&lt;0.0001). Mortality risk accountable to anemia was significantly higher for patients receiving coronary interventions (2.62 [2.35–2.92], p&lt;0.0001) as compared to purely diagnostic coronary angiography examinations (2.31 [2.15–2.47], p&lt;0.0001). Likewise, survival probability was slightly worse for patients with anemia in acute coronary syndrome (2.70 [2.29–3.12], p&lt;0.0001) compared to chronic coronary syndrome (2.60 [2.17–3.12], p&lt;0.0001). Interestingly, within the ACS entity, association of anemia with mortality was relevantly lower in STEMI patients (1.64 [1.10–2.44], p=0.014) as compared to NSTEMI and IAP (NSTEMI: 2.68 [2.09–3.44], p&lt;0.0001; IAP: 2.67 [2.06–3.47], p&lt;0.0001). Conclusion In this large registry of patients undergoing conventional coronary angiography, anemia was a frequent comorbidity. Anemia relevantly influences log-term survival, especially in patients receiving percutaneous coronary interventions. Our results confirm the important role of anemia for prognosis in patients with coronary artery disease, demonstrating the need for specific treatment options. Figure 1. Kaplan Meier analysis Funding Acknowledgement Type of funding source: None

scholarly journals Correlation between Peripheral Arterial Disease and Coronary Artery Disease in Bangladeshi Population- A Five Years Retrospective Study

2017 ◽  
Vol 11 (2) ◽  
pp. 79-84
Author(s):  
Syed Dawood Md Taimur ◽  
Mashhud Zia Chowdhury ◽  
Md Enamul Hakim
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Positive Family History ◽  
Arterial Disease ◽  
Coronary Angiogram ◽  
Vessel Disease ◽  
Artery Disease ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown.Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between presence of PAD and severity of CAD. Material &Methods: This five years retrospective study was conducted at invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, severity of coronary artery and peripheral artery disease.Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension were detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 88.3% and 58.4% had positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients 52 had both coronary and peripheral arterial disease which was statistically significant (p<.014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. Peripheral angiogram revealed 51.9% had superficial femoral artery disease, 24.7% had anterior tibial artery disease, 26% had posterior tibial artery disease, 15.6% had common iliac artery and common femoral artery disease and 2.6% had renal artery disease.Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.University Heart Journal Vol. 11, No. 2, July 2015; 79-84

P1737Influence of peripheral arterial disease on prognosis in patients with left main coronary artery disease treated with percutaneous coronary intervention

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Martinez Leon ◽  
A Adeba Garcia ◽  
D Garcia Iglesias ◽  
P Florez Llano ◽  
A Flores Fuentes ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Multivariate Analysis ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Arterial Disease ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Peripheral Arterial

Abstract Introduction Percutaneous coronary intervention (PCI) in patients with left main (LM) coronary artery disease is acquiring an important role in the last years as an alternative to coronary artery bypass grafting (CABG) in selected patients. The objective of the study was to evaluate predictors of mortality in patients with LM coronary artery disease treated with PCI. Methods Prospective and observational study of consecutive patients referred to our centre for coronary angiography, with LM coronary artery disease, whom PCI was decided in a “Heart team” as a strategy for revascularization between July 2015 and December 2017. Baseline clinical, analytical and coronary angiography data were collected. Follow-up was conducted in person or by telephone for a minimum of one year. We analysed the predictive variables of mortality by means of an uni and multivariate logistic regression model. In addition, a survival analysis was performed. Results A total of 191 patients were recruited. The average age was 72 years (±11.4), 79% males. 42% had previous documented coronary artery disease. PCI was performed in the context of acute coronary syndrome in 81% of them. The mean follow-up period was 17.9 months (± 8.3). After multivariate analysis, the following variables remained as independent predictors of mortality: the hemodynamic situation of the patient, assessed by the Killip-Kimball scale (OR 1.58, 95% CI 1.03–2.43; p=0.04) and the presence of peripheral arterial disease (PAD) (OR 2.61, 95% CI 1.03–6.67; p=0.04) (table 1). The ROC curve of the multivariate model showed an AUC of 0.796 (figure 1A). In the survival analysis, patients with PAD had a significantly lower survival, with a median survival of 6 months, compared to 13.9 months in those without PAD, with p=0.008 (figure 1B). Uni and multivariate analysis Univariate analysis Multivariate analysis OR (95% CI) p OR (95% CI) p Killip-Kimbal scale 1.94 (1.39–2.72) 0 1.58 (1.03–2.43) 0.04 LVEF 0.96 (0.93–0.99) 0.01 0.99 (0.95–1.03) 0.46 Mitral regurgitation 2.54 (1.12–5.63) 0.02 1.60 (0.55–4.56) 0.38 Number of affected vessels 1.96 (1.24–3.29) 0.01 1.78 (1.03–3.37) 0.05 PAD 2.54 (1.16–5.49) 0.02 2.61 (1.03–6.67) 0.,04 Figure 1 Conclusion Although PCI revascularization of LM coronary artery disease is an attractive alternative to CABG in selected patients, a word of caution should be raised in patients with PAD, as in the present study this variable was an important predictor of short-medium term mortality.

scholarly journals Association between Peripheral Arterial Disease and Coronary Artery Disease among Tobacco User Diabetic Patients

2017 ◽  
Vol 32 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Syed Dawood Md Taimur ◽  
M Maksumul Haq ◽  
MA Rashid ◽  
SM Keramat Ali ◽  
Md Shahjahan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Peripheral Artery ◽  
Tobacco User ◽  
Group I ◽  
Artery Disease ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) is a marker of increased risk for cardiovascular events and of poorer prognosis in patients with coronary artery disease (CAD). The prevalence of unknown PAD amongst patients with ACS varies between studies according to the mode of diagnosis.Aims: To evaluate the prevalence of peripheral arterial disease (PAD) in diabetic ACS patients with or without tobacco user by using ankle brachial index (ABI).We also assess the probable predictors of PAD among these patients.Methodology: This prospective observational study was conducted in the Department of Cardiology, Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh starting from 1st January 2016 to 30th April 2016 over a period of four months. A total of 60 patients were studied. They were grouped on the basis of their smoking habit. Diabetic patients with ACS and tobacco user (smoke and smoke less) in group I and without tobacco user in group II.Results: The mean age of the studied patients was 56.63 ± 8.95 years, range from 25-90 years. 73.30% was male and 26.70% was female. Twenty three patients of tobacco user in group-I (n=30) had peripheral artery disease and ten patients of group-II (n=30) had peripheral artery disease. It was statistically significant (p=0.003).Conclusion: There is correlation between peripheral arterial disease and coronary artery disease. Diagnosis and supervision of patients with PAD is important for preventing the local progression of the disease and effective secondary prevention of future coronary and cerebrovascular events.Bangladesh Heart Journal 2017; 32(1) : 3-9

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