Peripheral Artery Disease as a Predictor of Coronary Artery Disease in Patients Undergoing Coronary Angiography

Abstract

BackgroundPeripheral artery disease (PAD) may be a useful tool to predict coronary artery disease (CAD) in patients undergoing coronary angiography. If proven that PAD can be a good predictor of CAD, it can help in early and cost-effective diagnosis of CAD. MethodologyThis observational study was conducted from January 2020 to February 2021 in the cardiology unit of a tertiary care hospital. Participants older than 40 years, with a history of uncontrolled hypertension and unstable angina, who warranted the need of angiography were enrolled in study. After enrollment and recording history, these cases were assessed for the presence of PAD based on ankle brachial index (ABI). ABI values less than 0.9 were labelled as participants with PAD. Then these cases underwent coronary angiography at the same institute, and the presence of greater than 50% stenosis of any coronary vessel on angiography was taken as positive CAD. ResultsIn this study, PAD was identified in 152 (62.8%) participants. A total of 165 (68.1%) participants had greater than 50% stenosis on angiography. Out of 152 participants with ABI less than 0.9, 140 had greater than 50% stenosis on angiography. In total, 90 participants had ABI more than 0.9, of which 35 participants had greater than 50% stenosis. Sensitivity of PAD in predicting coronary artery stenosis was 80.0% (95% confidence interval [CI]: 73.30%-85.66%), specificity was 82.09% (95% CI: 70.80%-90.39%), and accuracy was 80.58% (95% CI: 75.02%-85.37%). ConclusionsOur study demonstrated that the sensitivity, specificity, and accuracy of PAD in predicting coronary artery stenosis were significant. Hence, we conclude that PAD can be an excellent predictor of CAD by helping in early and cost-effective diagnosis of CAD.

Serum Soluble Lectin-like Oxidized Low-Density Lipoprotein Receptor-1 (sLOX-1) Is Associated with Atherosclerosis Severity in Coronary Artery Disease

“…sLOX-1 has been demonstrated to be elevated in atherosclerotic carotid artery disease and lower limb arterial disease, which are not accounted for in our imaging measures. There is a significant correlation between disease burden in the coronaries and other vascular beds [ 45 , 46 ], but further research into sLOX-1 as a CAD biomarker will need to account for atherosclerosis in these other locations. The other main limitation of our study is the binary nature of the risk factor variables, which does not capture the continuous nature of these conditions in terms of severity.…”

Peripheral atherosclerosis evaluation through ultrasound: A promising diagnostic tool for coronary artery disease

“…In another study, Kumar et al rated the sensitivity of PAD in predicting coronary artery stenosis as 80%, the specificity as 82%, and the accuracy as 81%. 54 The Peripheral Arterial Disease in Interventional Patients Study (PIPS), a prospective cohort study revealed, that among patients who had confirmed CAD by CA (n = 5745), those with PAD had a higher prevalence of left main and multivessel CAD (87.2% vs. 75.5%, p = .006), and previous coronary artery bypass surgery (CABG) (35.8% vs. 23.1%, p = .008). 55 In post mortem study authors found among patients who died for stroke significant correlations between the deep femoral artery and left anterior descendent coronary arteries (r = .513; p = .012).…”

Peripheral atherosclerosis evaluation through ultrasound: a promising diagnostic tool for coronary artery disease

“…Diabetes significantly increased the risk of CAD in patients with PAD and the odds risk (OR) of having multi-vessel CAD was 2.5 (1.1-5.9, p=0.037). In another study, Kumar et al rated the sensitivity of PAD in predicting coronary artery stenosis as 80%, the specificity as 82%, and the accuracy as 81% 54 . The Peripheral Arterial Disease in Interventional Patients Study (PIPS), a prospective cohort study revealed, that among patients who had confirmed CAD by CA (n=5745), those with PAD had a higher prevalence of left main and multivessel CAD (87.2% vs. 75.5%, p=0.006), and previous coronary artery bypass surgery (CABG) (35.8% vs. 23.1%, p=0.008) 55 .…”