RELATION OF CORONARY ARTERY DISEASE TO ATHEROSCLEROTIC DISEASE IN THE CAROTID, ILIAC AND FEMORAL ARTERIES EVALUATED BY ULTRASOUND
Objective: To develop association between the angiographically significant coronary artery disease (CAD) and atherosclerotic disease in the carotid, iliac and femoral arteries as measured by ultrasound.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: This study was conducted at Adult cardiology department of AFIC/NIHD Rawalpindi for a period of six-months, from Jan 2019 to Jun 2019.
Methodology: Patients fulfilling the inclusion criteria were recruited in present study after their informed consent. Coronary angiography was performed by standard right-left diagnostic via the right radial or right femoral artery with a 6-French sheath. After angiogram patients with CAD were assessed for the atherosclerotic lesions in carotid and lower limb arteries, by ultrasound duplex scanning (UDS) performed by classified radiologist. The recorded variables were entered and analysed in SPSS.
Results: The mean age of the studied patients was 61.3 ± 10.725 years. A total of 100 patients underwent coronary angiography: 1 vessel was involved in 7% of patients, 2 vessels in 18%, 3 vessels in 62% and 3 vessel with LMS in 13%. Detecting peripheral atherosclerotic lesions by ultrasound duplex scan (UDS), increased intima-media thickness (IMT) or plaques in carotid arteries were found in 58 patients (58%). In lower limb arteries, IMT or plaques were present in patients (38%) and a stenosis >70% in 5 patients (5%). Severity of coronary artery disease (CAD) was correlated to extra-coronary atherosclerosis: Carotid and lower limb arterial atherosclerosis. Linear regression analysis revealed that the coronary artery disease is significantly related to lower extremities peripheral artery disease (p=0.001) and carotid Doppler findings (p=0.007). Our results showed that carotid artery stenosis and severe PAD (diffused atherosclerotic stenosis and complete occlusion in all segments) indicates coronary pathology significantly.
Conclusion: It is useful to screen the peripheral circulation by non-invasive tests, such as UDS in patients with multi-vessel CAD. Patients with extra-coronary atherosclerosis and angiographically confirmed ischemic heart disease need aggressive therapy for secondary prevention and a careful follow-up.