Extra Coronary Atherosclerosis in Patients With Documented Coronary Artery Disease

Background : Searching for extracoronaryatherosclerosis in patientswithdocumented coronary artery disease(CAD) is essential because thedetrimentallink between cardiac, renal,carotid and peripheral arterialdiseasesare common and atherosclerosisis well known as a polydistrectualdisease Objectives: To identifythe prevalence of renal arterystenosis(RAS), carotid artery atherosclerosis(CAA) and/or peripheralarterialdisease (PAD) in patientswithproven CAD and to illustratetheirrisk factors and to clarify theclinical,non invasive maneuvers fortheirdiagnosis as most of them areeithersilent or minimally symptomatizing.Study design: Cross sectionstudy. Patients and methods: Onehundred and thirty six cases (92 males and 44 females) with meanage of 66.2± 6.8 years, who weresubjected in the preceding year tocoronary angiography for acute coronarysyndrome and were coming forfollowup. Clinical examinationstressingon some atherosclerosisriskfactors (blood pressure, bloodglucoseand serum lipids), symptomsandsigns that may be specific for ischemiain different vascular territories,intermittent claudication, abdominalbruit, carotid bruit, anklebrachialindex (ABI), serum potassium,serum creatinine. Electrocardiography,echocardiography, Duplexultrasonographyfor carotid, renalandlower limb arteries werestressedupon. The examined caseswerethen grouped into those with eitherRAS, CAA, PAD versus caseswithoutextracoronary involvement. Results: Significant RAS (Duplex USscan) was detected in 33.82%, CAAin 29.41%, PAD in 27.94% and inonly 8.82% no significant extracoronarystenosis was detected. Significanthigh plasma glucose and smokingin PAD, while hypertension anddyslipidemiain RAS. Male genderandincreased waist circumferenceweresignificantly higher in CAA andsignificantlowering of ABI in PAD.Conclusion:Atherosclerosis involvingextracoronary territories is prevailingin patients with documentedCADand screening by US duplex ismandatoryto patients undergoing orhadundergone coronary interventions.