Prevalence of Severe Subclinical Coronary Artery Disease on Cardiac CT and MRI in Patients with Extra-cardiac Arterial Disease

M. A. M. den Dekker, J. J. A. M. van den Dungen, I. F. J. Tielliu, R. A. Tio, M. M. J. J. R. Jaspers, M. Oudkerk, R. Vliegenthart*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)

Abstract

Objective: Patients with extra-cardiac arterial disease (ECAD) are at high risk of coronary artery disease (CAD). Prevalence of silent, significant CAD in patients with stenotic or aneurysmal ECAD was examined. Early detection and treatment may reduce CAD mortality in this high-risk group.

Materials and methods: ECAD patients without cardiac complaints underwent computed tomography (CT) for calcium scoring, coronary CT angiography (cCTA) if calcium score was 1,000 or under, and adenosine perfusion magnetic resonance imaging (APMR) if there was no left main stenosis. Significant CAD was defined as calcium score over 1,000, cCTA-detected coronary stenosis of at least 50% lumen diameter, and/or APMR-detected inducible myocardial ischemia. In cases of left main stenosis (or equivalent) or myocardial ischemia, patients were referred to a cardiologist.

Results: The prevalence of significant CAD was 56.8% (95% Cl 47.5 to 66.0). One-hundred and eleven patients were included. Eighty-four patients (76%) had stenotic ECAD, and 27 (24%) had a-neurysmal disease. In patients with stenotic ECAD, significant coronary stenosis was present in 32 (38%) and inducible ischemia in eight (12%). Corresponding results in aneurysmal ECAD were eight (30%) and two (11%), respectively (p for difference >.05). Sixteen (19%) patients with stenotic and six (22%) with aneurysmal ECAD were referred to a cardiologist, with subsequent cardiac intervention in seven (44%) and three (50%), respectively (both p >.05).

Conclusions: Patients with stenotic or aneurysmal ECAD have a high prevalence of silent, significant CAD. (C) 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)680-689
Number of pages10
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume46
Issue number6
DOIs
Publication statusPublished - Dec-2013

Keywords

  • Coronary artery disease
  • Peripheral artery disease
  • Computed tomography
  • Magnetic resonance imaging
  • Prevalence
  • VASCULAR-SURGERY
  • COMPUTED-TOMOGRAPHY
  • MEDICAL THERAPY
  • ANGIOGRAPHY
  • REVASCULARIZATION
  • MANAGEMENT
  • MORTALITY
  • GUIDELINES
  • OUTCOMES
  • REGISTRY

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