Prevalence of multifocal atherosclerosis and comorbidity on symptomatic Cypriot inpatients

Abstract

Aim: Multifocal atherosclerotic disease or multifocal ischemic pathology (MAD) is an issue gaining a lot of attention by clinicians in recent years, due to its high impact on the morbidity and mortality of vascular patients. The coexistence of coronary artery disease (CAD), peripheral arterial disease (PAD) and carotid disease (CS) is being investigated in this study.

Methods: The study included 556 consecutive inpatients who were admitted to the Nicosia General Hospital in Cyprus for carotid endarterectomy, peripheral arterial reconstruction or coronary artery bypass. All patients were subjected to color duplex examination of the carotid vessels and to lower extremity Doppler study. Cardiac risk screening was performed on patients with PAD and CS. Comorbidity was evaluated by using the Cumulative Illness Rating Scale (CIRS).

Results: The prevalence of MAD in atherosclerotic patients was found very high (60.3%). The most frequent comorbidity was the coexistence of PAD and CAD (41.8%). The comorbidity burden of MAD patients, in comparison to that of patients with unifocal atherosclerotic disease, was evaluated to conclude that the burden in the first group (MAD) is significantly higher, not only in relation to the number of clinically relevant diseases that co-exist, but also to the severity of these diseases. Furthermore, functional status is negatively affected by the existence of multifocal ischemic pathology.

Conclusion: The high prevalence of MAD suggests the necessity of developing a systematic screening approach in the everyday practice. Apart from cardiovascular problems, other diseases affect the clinical situation of these patients. Therefore, it is important to investigate these problems pre- and postoperatively.