Background

Peripheral vascular disease (PVD) is known to be a risk factor of significant coronary artery disease (CAD). The aim of this study was to analyze the prevalence of CAD in patients of critical limb ischemia undergoing endovascular therapy in Asian population.

Methods

A total of 286 consecutive critical limb ischemia (CLI) patients (pts) were treated by endovascular therapy (EVT). 252 pts [male 76.1%, age 67.4 ± 10.4] who underwent coronary angioplasty (CAG) before or after EVT were enrolled between November 2004 and October 2012. CAD was defined as angiographic stenosis ≥ 50% and significant CAD as ≥ 70% stenosis.

Results

At baseline, the incidence of hypertension was 70.6%, diabetes 73.0%, dyslipidemia 12.6%, cerebrovascular disease 17%, chronic kidney disease 23.0% and atrial fibrillation 9.1%. 58% pts had wounds (including DM foot, 49.2%), gangrene 9.1%, claudication 11.9%, resting pain 21.4% and Buerger’s disease 3.1%. CAG results showed 62.5% with CAD and 50.6% with significant CAD. Among pts with significant CAD, 16.2% had undergone previous percutaneous coronary intervention (PCI) and 73 Pts (28.9%) received PCI during admission for EVT. Left main disease was observed in 8.3%, multi-vessel disease in 35.7%, and chronic total occlusion treated with medical therapy in 11.5%.

Conclusion

In this study, approximately 66.2% of pts with CLI undergoing EVT may have significant CAD in Asian population. Pts with PVD showed a significant association with CAD. Therefore, intensive anti- management and close clinical follow up would be needed.