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 (EVT) in a series of Asian population.

Methods

A total of 286 consecutive critical limb ischemia (CLI) patients (pts) were treated by EVT. A total 252 pts [male 76.1%, age 67.4 ± 10.4] who underwent coronary angiography (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%. Among the study population, 58% of pts had wounds (including DM foot, 49.2%), gangrene 9.1%, claudication 11.9%, resting ischemic pain 21.4% and Buerger’s disease 3.1%. CAG results showed that the prevalence of CAD was in 71.0% (179/252) and significant CAD in 57.5% (145/252). Left main disease was in 8.3% (21/252), multi-vessel disease 35.7% (90/252), and chronic total occlusion 11.5% (29/252). Among pts with significant CAD, 16.2% (41/252) of pts had history of previous percutaneous coronary intervention (PCI) and 28.9% of Pts (73/252) received PCI during admission for EVT. A total 78.6% (114/145) of significant CAD pts with CLI underwent PCI.

Conclusion

In this study, 57.5% of pts with CLI undergoing EVT had significant CAD and 78.6% of them underwent PCI, showing that advanced PVD was highly associated with significant CAD.

Copyright © 2014 Published by Elsevier Inc.