Prevalence of unknown peripheral arterial disease in patients with coronary artery disease: data in primary care from the IPSILON study.
BACKGROUND
Peripheral arterial disease (PAD) is a marker of increased risk of cardiovascular events and of poor prognosis in patients with coronary artery disease (CAD). The prevalence of unknown PAD among patients with CAD varies between studies according to the mode of diagnosis.


OBJECTIVE
To evaluate the prevalence of unknown PAD, diagnosed using the ankle-brachial index (ABI), in patients from the IPSILON study with a CAD diagnosis; to assess the profile of these patients; and to determine predictors of PAD.


METHODS
IPSILON was an observational, cross-sectional study. General practitioners measured ABI in 5679 consecutive adults aged 55 years or over with signs or symptoms suggestive of PAD (21.3%), a history of an atherothrombotic event (42.1%) or two or more cardiovascular risk factors (36.6%). This analysis focuses on the subgroup of patients with CAD and no other known overt atherothrombotic disease.


RESULTS
A total of 1340 patients presented with isolated CAD. PAD (ABI<0.90) was diagnosed in 26.6% of these patients; 16.2% were asymptomatic. Older age, symptoms suggestive of PAD and cardiovascular risk factors were found to be independent predictors of PAD in multivariable analysis.


CONCLUSIONS
Over 26% of patients with CAD present with unknown PAD, as diagnosed using ABI measurement. More than half of these patients are asymptomatic. Screening for PAD in patients with CAD will allow detection of a subpopulation at particularly high cardiovascular risk. An aggressive medical treatment strategy could help to improve their outcome.
Kownator
Serge
S
s.kownator@wanadoo.fr
Cambou
Jean-Pierre
JP
Cacoub
Patrice
P
Léger
Philippe
P
Luizy
François
F
Herrmann
Marie-Annick
MA
Priollet
Pascal
P
D000368:Aged; D000842:Ankle / Q000098:blood supply; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors