title: Asymptomatic Plaques of Lower Peripheral Arteries and Their Association with Cardiovascular Disease: An Autopsy Study.
abstract: OBJECTIVE
  Patients with peripheral artery disease (PAD) have a high prevalence of cardiovascular morbidity and mortality; however, majority of patients with PAD are asymptomatic. This study aimed to histologically evaluate whether asymptomatic, lower extremity artery plaques are associated with systemic atherosclerosis and the onset of cardiovascular disease (CVD) events using autopsy cases.
  
  
  METHODS
  We histologically investigated the atherosclerotic plaques of the common iliac, common carotid, coronary, and renal arteries from 121 autopsy cases without symptoms of PAD (mean age:67.6 years; 63% men; 83% non-CVD death). We evaluated the relationship between the degree of iliac artery atherosclerosis and that of other arteries, and also the presence of any CVD, myocardial infarction, stroke, and renal failure.
  
  
  RESULTS
  Advanced atherosclerotic plaques (American Heart Association ≥4) were present in 86 (72%) common iliac arteries in these cases. These arteries also showed high frequencies of calcification (66%), intraplaque hemorrhage (42%), and plaque disruption (24%). These advanced lesions were associated with age (≥60 years), sex (male), hypertension, diabetes, and smoking habit (all P＜0.05). Additionally, it was significantly associated with CVD (odds ratio, 95% confidence interval; 6.2, 2.2-22), myocardial infarction (6.4, 1.2-19), stroke (8.7, 1.7-16), and renal failure/hemodialysis (5.8, 1.1-11). Cases with advanced iliac artery plaques had advanced coronary and carotid atherosclerosis.
  
  
  CONCLUSIONS
  These results indicate that asymptomatic advanced plaques are frequently observed in common iliac arteries, and are associated with generalized atherosclerosis and CVD events.
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Miyazaki.
authors.forename: Eriko
authors.initials: E
authors.lastname: Nakamura
authors.affiliation: Department of Diagnostic Pathology, University of Miyazaki Hospital, Faculty of Medicine, University of Miyazaki.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Hemovascular Medicine and Artificial Organs, University of Miyazaki.
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwakiri
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Miyazaki.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamashita
authors.affiliation: Department of Diagnostic Pathology, University of Miyazaki Hospital, Faculty of Medicine, University of Miyazaki.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Moriguchi-Goto
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Miyazaki.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Maekawa
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Miyazaki.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Gi
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Miyazaki.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Asada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D002318:Cardiovascular Diseases / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000150:complications* / Q000473:pathology*; D058226:Plaque, Atherosclerotic / Q000150:complications* / Q000473:pathology*; D012307:Risk Factors; D061205:Vascular Calcification / Q000473:pathology
keywords: Asymptomatic peripheral artery disease; Autopsy; Cardiovascular disease; Generalized atherosclerosis