Clinical Features and Coronary Backgrounds of Coexistent Peripheral Vascular Disease in Japanese Coronary Artery Disease Patients

Abstract

By use of noninvasive tests (Doppler segmental pressure study, supraorbital Doppler flow analysis, and segmental plethysmography), coexistent carotid (CTD) or lower extremity peripheral vascular disease (PVD) were diagnosed and cor related with subjective symptoms, coronary risk factors (CRFs), coronary ar teriograms (CAGs), cardiac hemodynamics. and infarct size in 121 consecutive patients with documented coronary artery disease (CAD). PVD was found in 16.5%, CTD in 33.1%, and both PVD and CTD in 9.9% of the patients studied; 20% of PVD patients and 47.5% of CTD patients were asymptomatic with respect to coexistent PVD or CTD. There were no significant differences between the presence or absence of PVD or CTD as regards number of CRFs, Killip classifi cation, cardiac hemodynamics, or number of stenotic coronary arteries. However, serum creatine kinase (CK) and CKMB release curves in the PVD group showed significantly higher peak CK and peak CKMB values than those in the PVD(-) group (4096 ± 5408/282 ± 263 vs 1706 ± 1715/179 ± 186, p < 0.05) because of the higher prevalence (100%) of multivessel disease on CAG. Investigation of the relationship of CRFs to coexistent PVD revealed that the smoking ratio in men (86.7%) and the hypertension ratio in women (80%) were extremely high in PVD patients, and statistically significant differences between PVD( +) patients and PVD(-) groups were found with respect to the obesity ratio (p<0.05) in men and the hyper cholesterolemia ratio (p < 0.05) and obesity ratio (60%, p < 0.05) in women. On the other hand, in CTD patients, the smoking ratio (84%) and hypertension ratio (64%) in men and the hypertension ratio (86.7%) in women were extremely high, and significant differ ences between CTD(+) patients and CTD(-) patients were found with respect to the smoking ratio (p < 0.05) and obesity ratio (p < 0.05) in men and the smoking ratio (p < 0.05) in women. For the entire group of patients, the ankle/brachial pressure index was signifi cantly lower (p<0.05) when CAD patients displayed four or more CRFs, suggesting the progression of PVD with increasing number of CRFs. The incidence and clinical features of coexistent PVD or CTD in Japanese CAD patients were documented in the present study.