In:
Echocardiography, Wiley, Vol. 32, No. 12 ( 2015-12), p. 1771-1777
Abstract:
Atherosclerosis is a systemic disease and coronary artery disease is frequently associated with peripheral artery disease. As aortic and mitral valvular calcification ( VC ) share some etiopathogenetic mechanisms with atherosclerosis, we analyzed the risk profile and the echocardiographic characteristics of patients admitted for first acute coronary syndrome ( ACS ) to investigate whether the presence of VC could be a marker of asymptomatic hemodynamically significant peripheral atherosclerosis. Methods A total of 151 patients admitted for ACS without previous history of cardiovascular disease were consecutively enrolled. The presence of VC was identified by echocardiography; a carotid stenosis ≥50% by ultrasound identified carotid artery disease (Car AD ); an ankle–brachial index ≤0.9 or ≥1.4 identified lower extremity artery disease ( LEAD ). Significant peripheral atherosclerosis was defined by the presence of Car AD and/or LEAD . Results Peripheral atherosclerosis was diagnosed in 82 (54.3%) patients; isolated Car AD in 24, isolated LEAD in 20, both diseases in 38 patients. VC was present in 103 (68.2%) patients. By multivariate analysis, age ( OR = 1.059, 95% CI 1.007–1.113, P = 0.025), diabetes mellitus ( OR = 5.068, 95% CI 1.480–17.351, P = 0.010), VC ( OR = 7.422, 95% CI 2.421–22.880, P 〈 0.001), and multivessel CAD ( OR = 3.317, 95% CI 1.281–8.586, P = 0.013) were the only independent predictors of having peripheral atherosclerosis. C‐statistic for VC was not inferior to that obtained by age (0.728, 95% CI 0.649–0.797 vs. 0.800, 95% CI 0.727–0.861, P = 0.101) and to that obtained by the combination of multivessel CAD with diabetes (0.750; 95% CI 0.673–0.817, P = 0.635), and, furthermore, it was higher than that obtained by diabetes alone (0.620, 95% CI 0.538–0.698, P = 0.036). Conclusion Ruling out the presence of significant peripheral atherosclerosis should be routinely considered in patients with ACS showing VC at echocardiography.
Type of Medium:
Online Resource
ISSN:
0742-2822
,
1540-8175
DOI:
10.1111/echo.2015.32.issue-12
Language:
English
Publisher:
Wiley
Publication Date:
2015
detail.hit.zdb_id:
2041033-5
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