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Year : 2021  |  Volume : 5  |  Issue : 1  |  Page : 50-54

Unmasking previously unrecognized peripheral arterial disease in patients with coronary artery disease using continuous wave doppler using continuous wave doppler imaging : does the presence of peripheral arterial disease influence the clinicopathological profile of coronary artery disease? An Indian study

1 Department of Medine, Command Hospital Airforce, Bengluru, Karnataka, India
2 Department of Surgery, Command Hospital Airforce, Bengluru, Karnataka, India

Correspondence Address:
Dr. Rahul Sud
Department of Medicine, Command Hospital Airforce Bangalore, 560 007, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/bbrj.bbrj_171_20

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Background: It is well established that a significant number (30%) of patients suffering from coronary artery disease (CAD) also have underlying peripheral artery disease (PAD) as the only underlying risk factor. They are at increased risk of myocardial infarction as multiple vascular beds beyond the extremities are likely to be affected by atherosclerosis. A large percentage of high-risk patients with the coexistent disease may not be diagnosed with underlying PAD, as they were largely asymptomatic. This study aims to assess the prevalence of previously unrecognized PAD among patients with CAD, the risk association for various risk factors for CAD and PAD and also to determine the relationship between the presence of PAD and severity of CAD. Methods: A 3 years randomized, prospective, cross-sectional study done at Command Hospital Airforce Bangalore, India on patients of CADs, who were planned to undergoing coronary angiogram, were evaluated for the presence of PAD in lower extremities. The interactions between risk factors, Ankle Brachial Index (ABI), and CAD were examined by multiple stepwise regression analysis. Results: A total of 300 patients were studied. PAD has a prevalence of 14% in patients with CAD and it was strongly associated with disease severity. There was statistically significant association in patients with CAD which coexistent PAD with age (P = 0.001), smoking (P = 0.014), hypertension (P = 0.015), diabetes (P = 0.043), obesity (P= 0.004), history of previous cerebrovascular accident (P = 0.0138), number of coronaries involved (P = 0.02) and low-density lipoprotein (P = 0.001) levels as compared to CAD not associated with PAD. Conclusions: The high prevalence of PAD in patients who have CAD confirms the importance of active screening for PAD using ABI and requires aggressive management. We emphasize that clinicians should keep in mind that CAD patients would have other co-morbid vascular manifestations like PAD in order to minimize morbidity and mortality in these patients.

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