Prevalence of Coronary Heart Disease in Patients With Aortic Aneurysm and/or Peripheral Artery Disease

• Published in: The American journal of cardiology 2009-05, Vol.103 (9), p.1215-1220
• Main Authors: Hirose, Kenichi, MD, Chikamori, Taishiro, MD, Hida, Satoshi, MD, Tanaka, Hirokazu, MD, Igarashi, Yuko, MD, Watanabe, Yoshiko, MD, Koizumi, Nobusato, MD, Kawaguchi, Satoshi, MD, Obitsu, Yukio, MD, Shigematsu, Hiroshi, MD, Yamashina, Akira, MD
• Format: Article
• Language: English
• Subjects: Adenosine triphosphatase; Age Distribution; Aged; Aged, 80 and over; Analysis of Variance; Aneurysms; Aortic Aneurysm, Thoracic - diagnosis; Aortic Aneurysm, Thoracic - epidemiology; Biological and medical sciences; Blood and lymphatic vessels; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Chi-Square Distribution; Cohort Studies; Comorbidity; Coronary Angiography - methods; Coronary Disease - diagnosis; Coronary Disease - epidemiology; Coronary heart disease; Coronary vessels; Diseases of the aorta; Electrocardiography; Female; Follow-Up Studies; Heart; Humans; Male; Medical prognosis; Medical sciences; Middle Aged; Peripheral Vascular Diseases - diagnosis; Peripheral Vascular Diseases - epidemiology; Prevalence; Probability; Retrospective Studies; Severity of Illness Index; Sex Distribution; Statistics, Nonparametric; Survival Analysis; Time Factors; Tomography, Emission-Computed, Single-Photon - methods
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2009.01.033

Although the presence of coronary heart disease (CHD) was the major determinant of perioperative mortality and long-term prognosis in patients with aortic aneurysm (AA) and peripheral artery disease (PAD), the prevalence and severity of CHD in patients with individual vascular diseases was unknown. Adenosine triphosphate–loading myocardial single-photon emission computed tomography therefore was performed in 788 patients with vascular diseases of the aorta and peripheral arteries, with AA in 500, PAD localized in the lower-limb arteries in 183, and combined AA and PAD in 105. Patients with known CHD, such as those with previous myocardial infarction or revascularization procedures, were excluded. Myocardial single-photon emission computed tomography was analyzed using a 20-segment model, and summed stress scores and summed difference scores were calculated. Stress-induced myocardial ischemia was defined as a summed difference score ≥2. The presence of myocardial ischemia was highest in patients with combined PAD and AA (73%), followed by PAD (55%; p = 0.005), and the lowest in patients with AA (37%; p