Impact of Atherosclerotic Burden on Long-term Major Adverse Cardiovascular and Cerebrovascular Events

Background and Aim: Atherosclerotic burden is a key determinant of long-term cardiovascular outcomes. The objective of this study was to investigate the association between atherosclerotic burden and the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) in patients undergoing simultaneous diagnostic angiography of multiple vascular territories. Materials and Methods: This retrospective study included 153 consecutive patients who underwent concurrent angiography of the coronary, peripheral, carotid, subclavian, and renal arteries at a tertiary care hospital between January 2010 and March 2020. The patients were divided into two groups based on their atherosclerotic burden: the low group (<4 points, n=95) and the high group (≥4 points, n=58). The primary outcome was all-cause long-term mortality over a median follow-up period of 5.97 years. The secondary endpoint was the occurrence of MACCE at long-term follow-up. Results: A primary outcome event occurred in 34 of 58 patients (58.6%) in the high group and in 37 of 95 patients (38.9%) of 95 patients in the low group (P = 0.018). MACCE occurred in 40 of 58 patients (69.0%) in the high group and in 42 of 95 patients (44.2%) in the low group (P = 0.003). Propensity score matching demonstrated that the high group exhibited significantly higher primary outcome (59% vs. 33%, P = 0.007) and MACCE incidence (69% vs. 39%, P = 0.001) compared to the low group. Conclusion: Among patients who underwent simultaneous diagnostic angiography of multiple vascular territories, those with a high atherosclerotic burden had a higher risk of MACCE and mortality than those with a low atherosclerotic burden over a median follow-up of 5.97 years.