title: Occult vascular lesions in patients with atherothrombotic events: the AIRVAG cohort.
abstract: OBJECTIVE
  To determine clinical parameters that could predict occult vascular lesions (OVL) in patients with symptomatic atherosclerosis.
  
  
  METHODS
  Prospective evaluation of 269 consecutive patients with symptomatic atherosclerosis (cerebral 32%, peripheral vascular 15%, and coronary 53%): complete laboratory, ultrasound exams (carotids, aorta, heart), ankle-brachial index. OVL were defined as: abdominal aortic aneurysm, carotid artery stenosis > 50%, or left ventricular segmental contraction abnormalities when affecting a different vascular bed from the symptomatic. Clinical predictors of OVL were evaluated by logistic regression analysis.
  
  
  RESULTS
  OVL were found in 35 patients (13%): 12 abdominal aortic aneurysms, 21 carotid artery stenosis and 15 segmental left ventricular contraction abnormalities. OVL were associated with peripheral vascular disease (intermittent claudication or reduced ankle-brachial index), cigarette smoking, increased pulse pressure, microalbuminuria and hyperhomocysteinemia. By multivariate analysis, intermittent claudication (odds ratio 5.8; 95% CI 2.6-12.8) and microalbuminuria (OR 4.2; 95% CI 1.7-10.5) were strong independent predictors of OVL. Similar results were obtained when peripheral vascular disease was defined as reduced ankle-brachial index (OR 5.3; 95% CI 2.4-11.7).
  
  
  CONCLUSIONS
  Clinical and subclinical peripheral vascular disease, as well as microalbuminuria are strong independent predictors of OVL in atherosclerotic patients. A screening study of OVL may be warranted in these patients.
authors.affiliation: Department of Vascular Surgery, Fundación Hospital Alcorcón, Alcorcón, Madrid, Spain. slujanhuertas@fhalcorcon.es
authors.forename: S
authors.initials: S
authors.lastname: Luján
authors.forename: E
authors.initials: E
authors.lastname: Puras
authors.forename: L
authors.initials: L
authors.lastname: López-Bescós
authors.forename: J C
authors.initials: JC
authors.lastname: Belinchón
authors.forename: M
authors.initials: M
authors.lastname: Gutiérrez
authors.forename: C
authors.initials: C
authors.lastname: Guijarro
mesh_terms: D000419:Albuminuria / Q000150:complications; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000175:diagnosis; D016893:Carotid Stenosis / Q000150:complications* / Q000175:diagnosis; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications; D007383:Intermittent Claudication / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D018616:Ultrasonography, Doppler, Duplex; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology