Coronary Artery Disease in Patients with Atherosclerotic Peripheral Vascular Disease of Lower Extremities

ABSTRACT

BACKGROUND: Prevalence of the coronary artery disease(CAD) has been reported to be high in patients with the atherosclerotic peripheral vascular disease of lower extremities(PVD). However, the evaluation of the coexisting coronary artery disease(CAD) in patients with the PVD was often difficult due to limitation of the exercise capacity in these patients. This prespective study was designed to determine the prevalence, clinical characteristics of the associated CAD in patioents with PVDd, and to determine the value of the preoperative coronary angiogram as a predictor of the perioperative cardiovascular complications. METHODS: Eighty-two patients with PVD(78 male, age 62+/-7.8) were included from February 1991 to May 1993. Coronary angiogram was performed on the day of periperal angiogram in all patients and patients were divided into two group ; patients with CAD and patients without CAD. Clinical characteristics were compared, and among patients in whom revascularization surgery were undertaken, the incidences of the perioperative cardiovascular complications were compared between two groups. RESULTS: Coronary artery disease(CAD) was present in 50 patients(61%) of 82 PVD patients. In patients with CAD(N=50), only 72% of the patients were suspected for having coexisting CAD on the basis of chest pain and resting electrocardiogram. Revascularization surgery were performed in 46 patients and significantly high incidence of the perioperative acute myocardial infarction was observed in patients with coexisting CAD(4/25, 16% vs. 0/21, 0%). CONCLUSION: Considering the high prevalence of the CAD in patients with PVD and frequent occurrence of perioperative revascularization surgery in patients with PVD, we recommend that simultaneous coronary angiogram with aortography and peripheral angiogram should be considered in patients with PVD.