ORIGINAL ARTICLES   

International Angiology 2001 December;20(4):295-300

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

Occult aorto-iliac disease in patients with symptomatic coronary artery disease

Kafetzakis A., Giannoukas A. D., Kochiadakis G. *, Igoumenidis N. *, Vlachonikolis I. G. **, Tsetis D. ***, Katsamouris A.

From the Division of Vascular Surgery * Department of Cardiology, ** Department of Medical Statistics, and *** Department of Radiology, University Hospital of Heraklion University of Crete School of Medicine, Heraklion, Crete, Greece

Background. Atherosclerosis ­may ­affect ­the ­entire car­di­o­vas­cu­lar ­system ­despite ­absence of symp­toms. Early chang­es in ­the ­wall of ­the carot­id ­artery ­have ­been relat­ed to a high­er mor­bid­ity ­and mor­tal­ity ­from cor­o­nary ­artery dis­ease (­CAD). This ­study ­was con­duct­ed to inves­ti­gate ­the rela­tion­ship ­between ­the pres­ence of ­occult aor­to-­iliac dis­ease (­OAID) ­and cer­tain ­risk fac­tors ­with ­the sever­ity of ­CAD.
Methods. Two hun­dred ­and ­eighty-­four con­sec­u­tive ­patients sub­ject­ed to cor­o­nary angio­gra­phy (CA) ­were stud­ied. Additional imag­es of ­the aor­to-­iliac arte­ri­al seg­ment ­were tak­en. Patients ­with neg­a­tive CA or symp­to­mat­ic low­er ­limb arte­ri­al dis­ease (­LLAD) ­were exclud­ed ­from fur­ther anal­y­sis. In ­the remain­ing ­patients, ­the ­risk fac­tors (­age, smok­ing, dia­betes mel­lit­us, hyper­ten­sion, hyper­lip­i­de­mia ­and pos­i­tive fam­i­ly his­to­ry ­for ath­ero­scler­o­sis) ­and ­the sever­ity of cor­o­nary ­artery dis­ease (CAD) ­were ana­lyzed in rela­tion to ­the pres­ence or ­absence of ­OAID.
Results. Twelve ­patients ­with ­impaired ­renal func­tion ­were exclud­ed ­from ­the ­study. Negative CA ­was ­found in 12% (32/272) ­and symp­to­mat­ic ­LLAD ­was ­present in 14% (37/272). Eligible ­for fur­ther anal­y­sis ­were 203 ­patients ­with pos­i­tive CA ­and no ­LLAD. A hun­dred ­and ­ten of ­them ­had a pos­i­tive CA ­and ­the pres­ence of ­OAID where­as ­the remain­ing 93 ­patients ­had ­only a pos­i­tive CA. The ­patients ­with ­OAID ­had ­more ­severe ­CAD on CA (p=0.003). There ­was no dif­fer­ence ­ ­between ­the ­two ­groups con­cern­ing ­age ­and gen­der. The ­most com­mon ­risk fac­tors in ­both ­groups ­were hyper­cho­les­ter­o­le­mia ­and a pos­i­tive fam­i­ly his­to­ry ­but ­with a sig­nif­i­cant­ly high­er prev­a­lence in ­the ­patients ­with ­OAID (p=0.008 ­and p<0.001, respec­tive­ly).
Conclusions. The pres­ence of ­OAID in cor­o­nary ­patients ­was asso­ciat­ed ­with ­more ­severe ­CAD ­and ­with a sig­nif­i­cant­ly high­er prev­a­lence of hyper­cho­les­ter­o­le­mia ­and pos­i­tive fam­i­ly his­to­ry ­for ath­ero­scler­o­sis. This sub­set of ­patients ­may rep­re­sent ­those ­with ­more aggres­sive ath­ero­scler­o­sis.