title: Co-existence of carotid artery disease, renal artery stenosis, and lower extremity peripheral arterial disease in patients with coronary artery disease.
abstract: In atherosclerosis, carotid artery stenosis (CAS), renal artery stenosis (RAS), lower extremity peripheral arterial disease (PAD), and coronary artery disease (CAD) are common pathologic lesions; their interrelationship is, however, unclear. We studied concomitant multiple atherosclerotic lesions in patients with CAD to understand their prevalence and relations. A cross-sectional analysis was performed on data from consecutive patients who underwent nonemergent coronary angiography. Simultaneous carotid and renal artery Doppler studies and ankle-brachial systolic pressure measurements were reviewed to diagnose concomitant lesions and their severity. The study included 1,734 patients (aged 71 ± 9 years; 70% men), with prevalences of CAS, RAS, lower extremity PAD, and CAD of 6%, 7%, 13%, and 72%, respectively. In patients with CAD (n = 1,253), the prevalences of CAS, RAS, and lower extremity PAD were 7%, 9%, and 16%, respectively; 24% CAD patients had ≥1 additional atherosclerotic lesion. Significant interactions among the prevalences of these lesions were found. In addition, the extent of CAD and the prevalences of CAS, RAS, and lower extremity PAD were significantly correlated. Multivariate analysis supported these relationships. In conclusion, the prevalences of CAS, RAS, lower extremity PAD, and CAD were strongly interrelated in the study population; CAD severity was related to that of other atherosclerotic lesions. Additional systematic screening of other concomitant atherosclerotic lesions is recommended, especially in CAD patients having multivessel disease, left main disease, and/or already diagnosed with other concomitant atherosclerotic lesions.
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan. Electronic address: yoichiimori@me.com.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Imori
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Akasaka
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ochiai
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Oyama
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Tobita
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Shishido
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Nomura
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Futoshi
authors.initials: F
authors.lastname: Yamanaka
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sugitatsu
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Okamura
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Mizuno
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Arima
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Suenaga
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Murakami
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Matsumi
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Saeko
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takeshita
authors.affiliation: Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
mesh_terms: D000367:Age Factors; D000368:Aged; D006328:Cardiac Catheterization; D002340:Carotid Artery Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007866:Leg / Q000098:blood supply*; D008297:Male; D058729:Peripheral Arterial Disease / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012078:Renal Artery Obstruction / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler