Peripheral arterial disease and progression of coronary atherosclerosis

  • Hussein A
  • Uno K
  • Wolski K
 et al. 
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Abstract

Objectives: The purpose of this analysis was to characterize the progression of coronary atherosclerosis in patients with concomitant peripheral arterial disease (PAD). Background: Peripheral arterial disease is associated with adverse cardiovascular outcomes. The impact of concomitant PAD on coronary atherosclerosis progression in patients with coronary artery disease has not been well established. Methods: The burden and progression of coronary atherosclerosis was investigated in 3,479 patients with coronary artery disease with (n = 216) and without (n = 3,263) concomitant PAD who participated in 7 clinical trials that employed serial intravascular ultrasound imaging. Results: Patients with PAD had a greater percent atheroma volume (40.4 ± 9.2% vs. 38.5 ± 9.1%, p = 0.002) and percentage of images containing calcium (35.1 ± 26.2% vs. 29.6 ± 24.2%, p = 0.002), in association with smaller lumen volume (275.7 ± 101.6 mm3 vs. 301.4 ± 110.3 mm3, p < 0.001) and vessel wall volume (467.7 ± 166.8 mm3 vs. 492.9 ± 169.8 mm3, p = 0.01). On serial evaluation, patients with PAD demonstrated greater progression of percent atheroma volume (+0.58 ± 0.38 vs. +0.23 ± 0.3%, p = 0.009) and total atheroma volume (-0.17 ± 2.69 mm3 vs. -2.05 ± 2.15 mm3, p = 0.03) and experienced more cardiovascular events (26.3% vs. 19.8%, p = 0.03). In patients with PAD and without PAD, respectively, achieving levels of low-density lipoprotein cholesterol

Author-supplied keywords

  • atherosclerosis
  • intravascular ultrasound
  • peripheral arterial disease
  • risk factors

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