Background : Searching for extracoronary
atherosclerosis in patients
with
documented coronary artery disease
(CAD) is essential because the
detrimental
link between cardiac, renal,
carotid and peripheral arterial
diseases
are common and atherosclerosis
is well known as a polydistrectual
disease Objectives: To identify
the prevalence of renal artery
stenosis
(RAS), carotid artery atherosclerosis
(CAA) and/or peripheral
arterial
disease (PAD) in patients
with
proven CAD and to illustrate
their
risk factors and to clarify the
clinical,
non invasive maneuvers for
their
diagnosis as most of them are
either
silent or minimally symptomatizing.
Study design: Cross section
study. Patients and methods: One
hundred and thirty six cases (92 males and 44 females) with mean
age of 66.2± 6.8 years, who were
subjected in the preceding year to
coronary angiography for acute coronary
syndrome and were coming for
follow
up. Clinical examination
stressing
on some atherosclerosis
risk
factors (blood pressure, blood
glucose
and serum lipids), symptoms
and
signs that may be specific for ischemia
in different vascular territories,
intermittent claudication, abdominal
bruit, carotid bruit, ankle
brachial
index (ABI), serum potassium,
serum creatinine. Electrocardiography,
echocardiography, Duplex
ultrasonography
for carotid, renal
and
lower limb arteries were
stressed
upon. The examined cases
were
then grouped into those with either
RAS, CAA, PAD versus cases
without
extracoronary involvement. Results: Significant RAS (Duplex US
scan) was detected in 33.82%, CAA
in 29.41%, PAD in 27.94% and in
only 8.82% no significant extracoronary
stenosis was detected. Significant
high plasma glucose and smoking
in PAD, while hypertension and
dyslipidemia
in RAS. Male gender
and
increased waist circumference
were
significantly higher in CAA and
significant
lowering of ABI in PAD.
Conclusion:
Atherosclerosis involving
extracoronary territories is prevailing
in patients with documented
CAD
and screening by US duplex is
mandatory
to patients undergoing or
had
undergone coronary interventions.