Effect of peripheral arterial disease in patients undergoing percutaneous coronary intervention with intracoronary stents

Singh, Maneesh H.; Lennon, R.J.; Darbar, Dawood; Gersh, Bernard J.; Holmes, Dennis R.; Rihal, Charanjit S.

doi:10.1016/j.accreview.2004.11.049

Cited by 18 publications

(32 citation statements)

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“…28 Furthermore, coronary artery disease with peripheral artery disease and multivessel disease with complex lesion morphology have been more frequently compared with isolated coronary artery disease. 29 Conversely, recent clinical trials have clearly demonstrated that both the assessment of the classic categories, such as the number of diseased coronary arteries, and the complexity of coronary lesion morphology are useful for predicting major adverse cardiovascular and cerebrovascular events in patients who undergo percutaneous coronary intervention. 30,31 Taken together, these previous findings seem to support the present findings: that group D (IMT>0.9 mm and ABI<0.9) was associated with both a greater probability of the presence of coronary artery disease and also with significant coronary artery disease (>50% stenosis).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic utility of ankle-brachial index and carotid intima-media thickness as non-invasive predictors of the severity of coronary atherosclerosis

Kamal¹,

Elmasry²,

Elrashidy³

2018

JCCR

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Diagnostic utility of ankle-brachial index and carotid intima-media thickness as non-invasive predictors of the severity of coronary atherosclerosis Submit Manuscript | http://medcraveonline.com Citation: Kamal Y, Elmasry M, Elrashidy M, Diagnostic utility of ankle-brachial index and carotid intima-media thickness as non-invasive predictors of the severity of coronary atherosclerosis. Citation: Kamal Y, Elmasry M, Elrashidy M, Diagnostic utility of ankle-brachial index and carotid intima-media thickness as non-invasive predictors of the severity of coronary atherosclerosis.

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Section: Discussionmentioning

confidence: 99%

Diagnostic utility of ankle-brachial index and carotid intima-media thickness as non-invasive predictors of the severity of coronary atherosclerosis

Kamal¹,

Elmasry²,

Elrashidy³

2018

JCCR

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“…16 -19 However, only 2 studies noted a significant association between vascular disease and short-term mortality after PCI. 18,19 No previous study has evaluated the relationship between the burden of vascular disease and adverse outcomes after PCI.…”

Section: Discussionmentioning

confidence: 99%

“…16 -19 Unlike the current community-based study, 2 were single-center studies 17,19 and 2 analyzed patients from randomized controlled trials. 16,18 Furthermore, the definition of PAD differed by study; 2 studies 16,18 had no specific definition but were investigator recorded; 1 study 19 included symptomatic claudication, peripheral revascularization, abdominal aortic disease, or disease of the carotid, cranial, and extracranial arteries; and 1 study 17 used symptomatic PAD (history of intermittent claudication or lower extremity vascular interventions). Despite these differences, all studies found a significant association between concomitant vascular disease and future cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

Vascular Disease Burden and In-Hospital Outcomes Among Patients Undergoing Percutaneous Coronary Intervention in New York State

Berger

Petersen²,

Brown³

2009

Circ: Cardiovascular Interventions

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Background— The presence of atherosclerosis in extracardiac vascular beds is associated with an increased risk of adverse cardiovascular outcomes among stable patients with coronary artery disease (CAD). However, there is little data regarding the impact of the presence and extent of vascular disease on outcomes in patients with CAD undergoing percutaneous coronary intervention. Methods and Results— We analyzed 69 045 consecutive patients from the New York State Coronary Angioplasty Reporting System database who underwent percutaneous coronary intervention between 1998 and 1999. Vascular disease burden was assessed by history of aortoiliac, femoral-popliteal, and carotid disease. Patients were stratified into 3 groups: CAD alone, CAD and 1 additional site, and CAD and 2 or 3 additional sites. A logistic regression model was constructed to determine the relation between vascular disease burden and in-hospital mortality. Any history of vascular disease was present in 5915 (8.6%) of the population, of whom 4840 (82%) had CAD and 1 other disease location and 1075 (18%) had CAD and 2 or 3 other disease locations. There was a significant relationship between the number of disease locations and hospital mortality, ranging from 0.7% in patients with CAD alone to 2.0% and 2.6% for patients with 1 or ≥2 disease locations, respectively ( P <0.001). In unadjusted analysis, in-hospital mortality was ≈3-fold higher (odds ratio, 2.89; 95% CI, 2.31 to 3.60; P <0.001) and 4-fold higher (odds ratio, 3.78; 95% CI, 2.57 to 5.56; P <0.001) for inpatients with CAD and additional vascular disease at 1 site and ≥2 sites, respectively. After multivariable adjustment, each additional vascular bed affected was associated with a 50% increase in in-hospital mortality (odds ratio, 1.50; 95% CI, 1.27 to 1.78; P <0.001). Conclusions— Among patients with CAD undergoing percutaneous coronary intervention, vascular disease burden is associated with higher rates of adverse events and is an independent predictor of in-hospital mortality.

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“…5 Peripheral arterial disease (PAD) is common in individuals with severe CAD, especially in those presenting for percutaneous intervention (PCI). 6 Patients with concomitant CAD and PAD are at higher risk for morbidity and mortality in general and following revascularization. [6][7][8] The presence of PAD has been considered a relative contraindication to EECP therapy.…”

Section: Introductionmentioning

confidence: 99%

“…6 Patients with concomitant CAD and PAD are at higher risk for morbidity and mortality in general and following revascularization. [6][7][8] The presence of PAD has been considered a relative contraindication to EECP therapy. 3 Safety concerns include the possibility of skin ulceration -with subsequent impaired wound healing and risk of infection -and worsened lower limb blood flow due to extrinsic compression of the lower extremity arteries from the pneumatic cuffs of the EECP machine.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of enhanced external counterpulsation in patients with peripheral arterial disease

et al. 2009

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Peripheral arterial disease (PAD) is common in patients with severe coronary artery disease (CAD) and is considered a relative contraindication to external enhanced counterpulsation (EECP), but there are no data that define the efficacy and safety of EECP in patients with PAD. The International EECP Patient Registry (IEPR) was used to compare initial posttherapy and 2-year follow-up clinical outcomes and adverse event rates in patients with and without PAD. From January 2002 to October 2004, 2126 patients were enrolled in the IEPR, of whom 493 (23%) had a history of PAD. Immediately following EECP, the reduction in angina (≥ 1 Canadian Cardiovascular Society class) was similar in patients with and without PAD (76.6% vs 79.0%, p = 0.27) as was improvement in the Duke Activity Score Index (DASI) score (+4.7% vs +6.1%, p < 0.001). Both angina reduction and DASI score improvement were sustained at 2 years. PAD patients discontinued EECP more frequently (12.0% vs 8.5%, p < 0.05), but lower extremity ulceration did not occur more frequently in patients with PAD (3.7% vs 2.7%, p = 0.26). Rates of death (17.1% vs 8.6%, p < 0.001) and myocardial infarction (9.5% vs 5.0%, p < 0.001) were, as expected, higher in patients with PAD compared to patients without PAD at 2 years. In conclusion, while PAD patients constitute a high-risk cohort with known higher adverse event rates, EECP led to similar short-and longterm improvements in angina and quality of life for individuals with PAD compared to those without PAD.

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Effect of peripheral arterial disease in patients undergoing percutaneous coronary intervention with intracoronary stents

Cited by 18 publications

References 0 publications

Diagnostic utility of ankle-brachial index and carotid intima-media thickness as non-invasive predictors of the severity of coronary atherosclerosis

Diagnostic utility of ankle-brachial index and carotid intima-media thickness as non-invasive predictors of the severity of coronary atherosclerosis

Vascular Disease Burden and In-Hospital Outcomes Among Patients Undergoing Percutaneous Coronary Intervention in New York State

The efficacy and safety of enhanced external counterpulsation in patients with peripheral arterial disease

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