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A Journal on Cardiac, Vascular and Thoracic Surgery

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Peripheral arterial disease and concomitant coronary artery disease

The Journal of Cardiovascular Surgery 2009 February;50(1):109-21

language: English

Prognosis of patients with peripheral arterial disease

Welten G. M. J. M. 1, Schoutern O. 1, Chonchol M. 2, Hoeks S. E. 3, Bax J. J. 4, Van Domburg R. T. 3, Poldermans D. 5

1 Department of Vascular Surgery Erasmus Medical Centre, Rotterdam, The Netherlands
2 Division of Renal Diseases and Hypertension University of Colorado Health Sciences Centre Denver, CO, USA
3 Department of Cardiology Erasmus Medical Centre Rotterdam, The Netherlands
4 Department of Cardiology Leiden Medical Centre, Leiden, The Netherlands
5 Department of Anesthesiology Erasmus Medical Centre, Rotterdam, The Netherlands


The incidence of peripheral arterial disease (PAD) is on the increase and is associated with a major health concern in current practical care. The most common disease process underlying PAD is atherosclerosis. Atheroscle-rosis is a complex generalized disease affecting several arterial beds, including the peripheral and coronary circulation. Especially in patients with PAD, high incidences of coronary artery disease (CAD) have been observed, which may be asymptomatic or symptomatic. The prognosis of patients with PAD is related to the presence and extent of underlying CAD. In patients with PAD undergoing major vascular surgery, cardiac complications are the major cause of perioperative morbidity and mortality and indicate a high-risk for adverse long-term cardiac outcome. In order to improve outcome for PAD patients, assessment and aggressive therapy of atherosclerotic risk factors and usage of cardio-protective medications is recommended. Unfortunately, substantial differences in risk factor management and treatment and long-term outcome have been reported between PAD and CAD patients.

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