Correlation of Coronary Artery Disease in Patients with Peripheral Artery Disease: Cross-Sectional Study

Main Article Content

Ajab Khan
Muhammad Gibran Khan
Imran Khan Khalil
Shahzad Khan
Hussain shah
Haider Ali Khan

Abstract

Background Peripheral Artery Disease (PAD) and Coronary Artery Disease (CAD) represent two facets of atherosclerotic cardiovascular disease, significantly impacting global health. Despite their high morbidity and mortality rates, the epidemiological and clinical nexus between PAD and CAD remains underexplored. Understanding the interrelation of these conditions is paramount for optimizing diagnostic and therapeutic strategies.


Objective This study aimed to delineate the incidence and clinical correlation of CAD in patients diagnosed with PAD, thereby providing insights into the epidemiological characteristics and enhancing the clinical management of these conditions.


Methods A cross-sectional analysis was conducted at Afridi Medical Complex's departments of vascular surgery and cardiology from 2021 to 2023. One hundred PAD patients referred for peripheral angiography were enrolled. Demographic data, Ankle Brachial Index (ABI) readings, ejection fraction percentages, and the presence of multivessel disease were evaluated. Statistical analyses were performed using SPSS version 25, focusing on mean, median, range, and significance levels to elucidate the prevalence of CAD among PAD patients.


Results The study revealed a median age of 58 years among participants, with a significant male predominance (84%). ABI analysis showed that 74% and 108% of patients had mild and moderate PAD severity, respectively. The incidence of CAD in the PAD population was 56%, with angiographic assessments indicating single, double, and triple vessel disease in 23.21%, 39.29%, and 37.5% of patients, respectively. Notably, diabetes and dyslipidemia were prominent predictors of CAD presence in PAD patients.


Conclusion The high prevalence of CAD in PAD patients underscores the critical need for comprehensive cardiovascular risk assessment and suggests the potential benefit of routine coronary angiography in symptomatic PAD cases, particularly among those with diabetes and dyslipidemia. This study reinforces the intertwined nature of PAD and CAD, advocating for an integrated approach to the diagnosis and management of these atherosclerotic conditions.

Article Details

How to Cite
Khan, A., Khan , M. G., Khalil , I. K., Khan, S., shah , H., & Khan, H. A. (2024). Correlation of Coronary Artery Disease in Patients with Peripheral Artery Disease: Cross-Sectional Study. Journal of Health and Rehabilitation Research, 4(1), 1490–1497. https://doi.org/10.61919/jhrr.v4i1.578
Section
Articles
Author Biographies

Ajab Khan, Afridi Medical Complex and Teaching Hospital Pakistan.

Assistant Professor, Afridi Medical Complex and Teaching Hospital, Pakistan.

Muhammad Gibran Khan , Peshawar General Hospital Hayatabad Pakistan.

Assistant Professor, Peshawar General Hospital Hayatabad, Pakistan.

Imran Khan Khalil , MMC General Hospital Pakistan.

Consultant cardiac surgeon, MMC General Hospital, Pakistan.

Shahzad Khan, Peshawar General Hospital Hayatabad Pakistan.

Registrar, Peshawar General Hospital Hayatabad, Pakistan.

Hussain shah , Peshawar General Hospital Hayatabad Pakistan.

Registrar, Peshawar General Hospital Hayatabad, Pakistan.

Haider Ali Khan, Afridi Medical Complex Peshawar Pakistan.

Consultant Physiotherapist, Physiotherapy Dept, Afridi Medical Complex Peshawar, Pakistan.

References

Builyte IU, Baltrunas T, Butkute E, et al. Peripheral artery disease patients are poorly aware of their disease. Scand Cardiovasc J. 2019;53:373–378.

Iyer SR, Annex BH. Therapeutic angiogenesis for peripheral artery disease: lessons learned in translational science. JACC Basic Transl Sci. 2017;2:503–512.

Song P, Rudan D, Zhu Y, et al. Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis. Lancet Glob Health. 2019;7:e1020–e1030.

Patel T, Baydoun H, Patel NK, et al. Peripheral arterial disease in women: the gender effect. Cardiovasc Revasc Med. 2020;21:404–408.

Malakar AK, Choudhury D, Halder B, et al. A review on coronary artery disease, its risk factors, and therapeutics. J Cell Physiol. 2019;234:16812–16823.

Choi BG, Hong JY, Rha SW, et al. Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention. PLoS One. 2021;16:e0251542.

Fonarow GC, Teltsch DY, Cohen A, et al. Incidence, prevalence, characteristics, and outcomes in patients with newly-diagnosed coronary artery disease or peripheral artery disease in real-world population of the United States. Circulation. 2018;138(Suppl_1):16575. [Abstract].

Goyal A, Kahlon P, Jain D, et al. Trend in prevalence of coronary artery disease and risk factors over two decades in rural Punjab. Heart Asia. 2017;9:e010938.

Krishnan MN, Geevar Z, Mohanan PP, et al. Prevalence of peripheral artery disease and risk factors in the elderly: a community-based cross-sectional study from northern Kerala, India. Indian Heart J. 2018;70:808–815.

Trevisan L, Cautela J, Resseguier N, et al. Prevalence and characteristics of coronary artery disease in heart failure with preserved and mid-range ejection fractions: a systematic angiography approach. Arch Cardiovasc Dis. 2018;111:109–118.

Sirasapalli CN, Christopher J, Ravilla V. Prevalence and spectrum of coronary artery anomalies in 8021 patients: a single center study in South India. Indian Heart J. 2018;70:852–856.

Dayal R, Singh S. Prevalence of risk factors for coronary artery disease in rural population in North India: a cross-sectional study. Eur J Mol Clin Med. 2020;7:5748–5759.

US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening for peripheral artery disease and cardiovascular disease risk assessment with the ankle-brachial index: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;320:177–183.

Sigvant B, Hasvold P, Kragsterman B, et al. Cardiovascular outcomes in patients with peripheral arterial disease as an initial or subsequent manifestation of atherosclerotic disease: results from a Swedish nationwide study. J Vasc Surg. 2017;66:507–514.e1.

Zahergivar A, Kocher M, Waltz J, et al. The diagnostic value of non-contrast magnetic resonance coronary angiography in the assessment of coronary artery disease: a systematic review and meta-analysis. Heliyon. 2021;7:e06386.

Derbas LA, Patel KK, Muskula PR, et al. Variability in utilization of diagnostic imaging tests in patients with symptomatic peripheral artery disease. Int J Cardiol. 2021;330:200–206.

Barkat M, Key A, Ali T, et al. Effect of treatment of peripheral arterial disease on the onset of anaerobic exercise during cardiopulmonary exercise testing. Phys Rep. 2021;9:e14815.

Andreini D, Pontone G, Mushtaq S, et al. Long-term prognostic impact of CT-Leaman score in patients with non-obstructive CAD: results from the COronary CT angiography evaluation for clinical outcomes international multicenter (CONFIRM) study. Int J Cardiol. 2017;231:18–25.

Frank U, Nikol S, Belch J, et al. ESVM Guideline on peripheral arterial disease. Vasa. 2019;48:1–79.

Bakshi V. Determination of peripheral artery disease using Ankle-Brachial index. Asian J Pharm. 2019;12:04.

da Cunha GR, Brugnarotto RJ, Halal VAE, et al. Prevalence of peripheral arterial disease in patients with heart failure with preserved ejection fraction. Clinics (Sao Paulo). 2019;74:e978.

Kamil S, Sehested TSG, Carlson N, et al. Diabetes and risk of peripheral artery disease in patients undergoing first-time coronary angiography between 2000 and 2012 - a nationwide study. BMC Cardiovasc Disord. 2019;19:234.

Aboyans V, Desormais I, Magne J, et al. Renal artery stenosis in patients with peripheral artery disease: prevalence, risk factors, and long-term prognosis. Eur J Vasc Endovasc Surg. 2017;53:380–385.

Bauersachs R, Zeymer U, Briere JB, et al. Burden of coronary artery disease and peripheral artery disease: a literature review. Cardiovasc Ther. 2019;2019:8295054.