High prevalence of peripheral arterial disease in Korean patients with coronary or cerebrovascular disease

Sanghyun Ahn, Yang Jin Park, Sang-Il Min, Seong Yup Kim, Jongwon Ha, Sang Joon Kim, Hyo-Soo Kim, Byung-Woo Yoon, Seung-Kee Min, Sanghyun Ahn, Yang Jin Park, Sang-Il Min, Seong Yup Kim, Jongwon Ha, Sang Joon Kim, Hyo-Soo Kim, Byung-Woo Yoon, Seung-Kee Min

Abstract

This prospective study surveyed the prevalence of peripheral arterial disease (PAD) in Korean patients with coronary arterial disease (CAD) or cerebrovascular disorder (CVD). From March 2010, 576 hospitalized patients in cardiovascular or stroke center were enrolled as the study group. Ankle-brachial index (ABI) was measured and the cut-off point for diagnosing PAD was ≤ 0.9 at rest. A total of 424 hospitalized patients in the Department of Surgery and aged ≥ 50 yr was enrolled as the control group. The prevalence of PAD was significantly higher in the study group than the control group (7.6% vs 1.7%; P < 0.001). To analyze the relationship of other vascular diseases and PAD, the patients were regrouped; group A (no CAD or CVD), group B (CAD only), group C (CVD only), and group D (CAD and CVD). Compared with group A, those with other vascular diseases (group B, C, D) had significantly higher prevalence of PAD, diabetes, dyslipidemia, renal insufficiency and claudication. The trend that patients with CAD or CVD are at risk of PAD is observed in this cross-sectional study in Koreans. Routine ABI measurement is recommended in these high-risk groups for early detection and proper management of PAD.

Keywords: Ankle-Brachial Index; Cerebrovascular Disorder; Coronary Artery Disease; Peripheral Arterial Disease; Prevalence.

Figures

Fig. 1
Fig. 1
Typical overlap in vascular diseases affecting different territories. PAD, peripheral artery disease.

References

    1. Welten GM, Schouten O, Hoeks SE, Chonchol M, Vidakovic R, van Domburg RT, Bax JJ, van Sambeek MR, Poldermans D. Long-term prognosis of patients with peripheral arterial disease: a comparison in patients with coronary artery disease. J Am Coll Cardiol. 2008;51:1588–1596.
    1. Criqui MH, Langer RD, Fronek A, Feigelson HS, Klauber MR, McCann TJ, Browner D. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med. 1992;326:381–386.
    1. Bendermacher BL, Teijink JA, Willigendael EM, Bartelink ML, Peters RJ, de Bie RA, Büller HR, Boiten J, Langenberg M, Prins MH. A clinical prediction model for the presence of peripheral arterial disease: the benefit of screening individuals before initiation of measurement of the ankle-brachial index: an observational study. Vasc Med. 2007;12:5–11.
    1. Sprynger M, Fassotte C, Verhaeghe R. The ankle-brachial pressure index and a standardized questionnaire are easy and useful tools to detect peripheral arterial disease in non-claudicating patients at high risk. Int Angiol. 2007;26:239–244.
    1. Baxter GM, Polak JF. Lower limb colour flow imaging: a comparison with ankle: brachial measurements and angiography. Clin Radiol. 1993;47:91–95.
    1. Resnick HE, Lindsay RS, McDermott MM, Devereux RB, Jones KL, Fabsitz RR, Howard BV. Relationship of high and low ankle brachial index to all-cause and cardiovascular disease mortality: the Strong Heart Study. Circulation. 2004;109:733–739.
    1. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Third report of the NCEP expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. Circulation. 2002;106:3143–3421.
    1. Björck M, Bergqvist D, Eliasson K, Jansson I, Karlström L, Kragsterman B, Lundell A, Malmstedt J, Nordanstig J, Norgren L, et al. Twenty years with the Swedvasc Registry. Eur J Vasc Endovasc Surg. 2008;35:129–130.
    1. Bhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL, Goto S, Liau CS, Richard AJ, Röther J, et al. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA. 2006;295:180–189.
    1. Newman AB, Siscovick DS, Manolio TA, Polak J, Fried LP, Borhani NO, Wolfson SK Cardiovascular Heart Study (CHS) Collaborative Research Group. Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Circulation. 1993;88:837–845.
    1. Hirsch AT, Murphy TP, Lovell MB, Twillman G, Treat-Jacobson D, Harwood EM, Mohler ER, 3rd, Creager MA, Hobson RW, 2nd, Robertson RM, et al. Gaps in public knowledge of peripheral arterial disease: the first national PAD public awareness survey. Circulation. 2007;116:2086–2094.
    1. Kweon SS, Shin MH, Park KS, Nam HS, Jeong SK, Ryu SY, Chung EK, Choi JS. Distribution of the ankle-brachial index and associated cardiovascular risk factors in a population of middle-aged and elderly Koreans. J Korean Med Sci. 2005;20:373–378.
    1. Kullo IJ, Bailey KR, Kardia SL, Mosley TH, Jr, Boerwinkle E, Turner ST. Ethnic differences in peripheral arterial disease in the NHLBI Genetic Epidemiology Network of Arteriopathy (GENOA) study. Vasc Med. 2003;8:237–242.
    1. Poredos P, Jug B. The prevalence of peripheral arterial disease in high risk subjects and coronary or cerebrovascular patients. Angiology. 2007;58:309–315.
    1. Holland-Letz T, Endres HG, Biedermann S, Mahn M, Kunert J, Groh S, Pittrow D, von Bilderling P, Sternitzky R, Diehm C. Reproducibility and reliability of the ankle-brachial index as assessed by vascular experts, family physicians and nurses. Vasc Med. 2007;12:105–112.
    1. Santo Signorelli S, Anzaldi M, Fiore V, Catanzaro S, Simili M, Torrisi B, Neri S. Study on unrecognized peripheral arterial disease (PAD) by ankle/brachial index and arterial comorbidity in Catania, Sicily, Italy. Angiology. 2010;61:524–529.

Source: PubMed

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