title: [Similarities and differences among patients with symptomatic atherosclerosis affecting several territories. The AIRVAG cohort (Integral Attention to Global VAscular Risk)].
abstract: OBJECTIVE
  Even though atherosclerosis is a systemic disease, few prospective studies have evaluated in a thorough and systematic manner the whole vascular tree in patients with clinical damage of different territories.
  
  
  METHODS
  Prospective protocolized study of 269 consecutive patients younger than 70, attended because of symptomatic arteriosclerosis of any territory -53% coronary (CHD), 32% cerebrovascular (CVD), 15% peripheral (PVD)-. Patients underwent evaluation of risk factors and their control, systematic non-invasive study of the vascular tree (Doppler-ultrasound) and comparison between groups according to the index territory.
  
  
  RESULTS
  Even though all risk factors were represented in the 3 groups, male sex, smoking and diabetes were more frequent in PVD and dyslipemia was more common in CHD (p < 0.05) Abdominal aortic diameter and carotid intima-media thickness were similar for all groups, while the number of carotid plaques was higher in PVD. CHD patients more often presented left ventricular hypertrophy and reduced ejection fraction. PVD patients showed a marked reduction of the ankle-brachial index as well as increased C-reactive protein and homocysteine (p < 0.05). Severe unsuspected vascular lesions were found in 13% of cases (95% confidence interval, 9.5-17.6%). Risk factor control was better for CHD, followed by CVD and PVD, but was globally poor.
  
  
  CONCLUSIONS
  The systematic evaluation of the vascular tree detects generalized atherosclerotic lesions, in some cases severe and clinically unsuspected. New markers to identify patients at very high risk are necessary. Peripheral vascular disease identifies a group of patients of particular risk. Risk factor control is deficient, particularly among PVD patients.
authors.affiliation: Unidad de Medicina Interna, Fundación Hospital Alcorcón, Alcorcón, Madrid, España. cguijarro@fhalcorcon.es
authors.forename: Carlos
authors.initials: C
authors.lastname: Guijarro
authors.forename: Nieves
authors.initials: N
authors.lastname: Mesa
authors.forename: Juliana
authors.initials: J
authors.lastname: Jiménez
authors.forename: Enrique
authors.initials: E
authors.lastname: Puras
authors.forename: Carmen
authors.initials: C
authors.lastname: Sánchez
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Fernández-Sánchez
authors.forename: Isabel
authors.initials: I
authors.lastname: González-Anglada
authors.forename: Salvador
authors.initials: S
authors.lastname: Luján
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Belinchón
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Casas
authors.forename: Lorenzo
authors.initials: L
authors.lastname: López-Bescós
mesh_terms: D000368:Aged; D000886:Anthropometry; D001161:Arteriosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography