Key result
Concomitant peripheral arterial disease in acute coronary syndrome patients was associated with a 6.8-point higher average SYNTAX score (p=0.034) than in those without PAD.
Why the study?
More than 50% of patients with peripheral artery disease (PAD) also have coronary artery disease, raising concerns about potential differences in hospital mortality and the need for immediate revascularization across acute coronary syndrome (ACS) types when PAD is present.
Does the presence of peripheral artery disease (PAD) increase coronary artery disease severity (SYNTAX score) and procedural requirements in patients admitted with acute coronary syndrome (ACS)?
Observational (n=100)
Does the presence of peripheral artery disease (PAD) increase coronary artery disease severity (SYNTAX score) and procedural requirements in patients admitted with acute coronary syndrome (ACS)?
Answers are grounded in this paper and cite their sources.
Patients presenting with acute coronary syndrome who have concomitant peripheral artery disease exhibit significantly higher coronary anatomical complexity (SYNTAX score) and more frequent left main disease requiring complete revascularization.
BACKGROUND: Peripheral artery disease (PAD) refers to the extracardiac localization of atherosclerotic disease, generally in arteries that vascularize the lower limbs. More than 50% of patients with PAD also have coronary artery disease (CAD). There are concerns about possible differences in mortality rates among hospitalized patients and the need for immediate revascularization during hospital stay across different types of acute coronary syndrome (ACS) when PAD is present. METHODS: This was a retrospective study that included 100 patients admitted with ACS between October 2019 and May 2022. Participants were divided into two groups: those with ACS and PAD (n=32) and those without PAD (n=68). We used the SYNTAX score to evaluate the severity of coronary artery disease, the amount of contrast and dose area product (DAP) dosage per patient during the procedure and how these factors vary. RESULTS: There was a 6.8 higher average SYNTAX score among patients with ACS and PAD (p=0.034), which could negatively affect their prognosis. In addition, there was a 12.7-point increase in the SYNTAX score for patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) and PAD (p=0.008). Patients with ACS and concomitant PAD were more likely to require complete revascularization of the left main disease. CONCLUSION: Patients with PAD and concomitant ACS have more severe CAD, with more frequent involvement of the left main artery than those without PAD.
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Gherasie et al. (2024) conducted an observational in Acute coronary syndrome (ACS) (n=100). Concomitant peripheral arterial disease (PAD) vs. ACS without PAD was evaluated on Coronary artery disease severity evaluated by SYNTAX score (MD 6.8, p=0.034). Concomitant peripheral arterial disease in acute coronary syndrome patients was associated with a 6.8-point higher average SYNTAX score (p=0.034) than in those without PAD.
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