| 김은경¹ , 양정훈¹ , 송필상¹ , 송영빈¹ , 최진호¹ , 권현철¹ , 이상훈¹ , 홍경표¹ , 박정의¹ , 최승혁¹ |
Background: As an indicator of multifocal atherosclerosis, peripheral artery disease (PAD) has known to be an important marker in risk stratification of patients with coronary artery disease (CAD). We sought to determine the prevalence of PAD in patients with coronary disease and show the relation between ankle-brachial index (ABI) and severity of CAD.
Methods: The study was carried out at single center from August 2009 to August 2011. A total 756 patients (75.5% male; mean age 63.3 ± 11.0 years) with CAD undergoing percutaneous coronary intervention (PCI) were enrolled. Diagnosis of PAD was made using the ABI of 0.9 or less and more than 1.3 with 0.7 or less toe-brachial index. To assess the severity of CAD, we investigated whether multi-vessel and left main coronary lesion was involved or not.
Results: The prevalence of PAD was 9.9% (Right, left ABI: 0.75 [0.60 – 0.82], 0.76 [0.62-0.83]) in all patients, 15.3% among patients over 70 years and did not differ between genders (9.8% vs 10.3%, p = 0.855). Patients with PAD had higher prevalence of left main coronary lesion (13.3% vs 5.9%, p = 0.024) and more frequently involved multi-vessel lesion (73.3% vs 53.5%, p = 0.001). Alternatively, patients with left main coronary lesion had a twofold higher risk of being diagnosed with PAD (20%). PAD had higher prevalence in patients presented with atherosclerotic coronary disease than those presented with acute coronary syndrome, which was not statistically significant (11.0% vs 8.5%, p = 0.245). In univariate analysis, the presence of PAD was a single predictor of multi-vessel coronary artery disease (OR 2.395, 95% CI 1.405 – 4.083, p = 0.001) and left main coronary lesion (OR 2.465, 95% CI 1.178 – 5.159, p = 0.017).
Conclusion: Our study confirmed a high prevalence of PAD in patients with coronary artery disease. In patients with coronary artery disease, abnormal ABI was associated multi-vessel or left main disease. ABI-based PAD screening should be implemented in all patients with coronary artery disease, especially in those with severe extent.
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