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. 2015 Aug;241(2):687-91.
doi: 10.1016/j.atherosclerosis.2015.06.029. Epub 2015 Jun 23.

Co-existence of vascular disease in different arterial beds: Peripheral artery disease and carotid artery stenosis--Data from Life Line Screening(®)

Louai Razzouk  1 , Caron B Rockman  2 , Manesh R Patel  3 , Yu Guo  3 , Mark A Adelman  2 , Thomas S Riles  2 , Jeffrey S Berger  4
Affiliations

Co-existence of vascular disease in different arterial beds: Peripheral artery disease and carotid artery stenosis--Data from Life Line Screening(®)

Louai Razzouk et al. Atherosclerosis. 2015 Aug.

Abstract

Background: Atherosclerosis is a systemic vascular disorder, involving multiple arterial territories. This project sought to investigate the relationship between lower extremity peripheral artery disease (PAD) and carotid artery stenosis (CAS) in a large self-referred population.

Methods: Data from the ankle brachial index (ABI) and carotid duplex ultrasound were analyzed from 3.67 million US subjects in the Life Line Screening program between 2004 and 2008. PAD was defined by ABI<0.9 and CAS was defined by greater than 50% stenosis. Multivariate logistic regression analysis was used to estimate odds of CAS by PAD status and severity.

Results: Mean age of the population was 63.7 ± 10.6 years and 64% were women. The prevalence of PAD and CAS was 4.1% and 3.9%, respectively. Subjects with PAD had a higher prevalence of CAS than those without PAD (18.8% vs. 3.3%, P < 0.0001). In multivariate analysis, PAD was associated with greater odds of CAS (OR 3.28, 95% CI 3.22-3.34). Both symptomatic (OR 3.66, 95% CI 3.58-3.75) and asymptomatic PAD (OR 2.91, 95% CI 2.84-2.98) was associated with CAS. Increasing severity of PAD was associated with greater odds of CAS (OR 2.32, 3.61, 4.19, 5.14, and 7.59 for ABI categories 0.81-0.90, 0.71-0.80, 0.61-0.70, 0.41-0.60, ≤0.40, respectively).

Conclusion: Presence and severity of PAD was associated with prevalence of CAS in the large self-referred and self-paying Life Line cohort, regardless of lower extremity symptoms.

Keywords: Carotid artery stenosis; Peripheral artery disease.

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Conflict of interest statement

Conflicts of Interest Disclosures

There are no potential conflicts of interest. The authors gratefully acknowledge the participation and generosity of Life Line Screening (Cleveland, OH), who provided these data free of charge for the purposes of research and with no restrictions on its use for research or resultant publications.

Figures

Figure 1
Figure 1. Frequencies of CAS severity by the presence of PAD and symptomatic status of subjects with PAD
CAS, carotid artery stenosis; PAD, peripheral artery disease
Figure 2
Figure 2. Multivariate logistic regression analyses of moderate to severe CAS by (a) presence of PAD and (b) symptomatic status of subjects with PAD
CAS, carotid artery stenosis; PAD, peripheral artery disease
Figure 3
Figure 3. Frequencies of CAS Severity by the degree of PAD severity
CAS, carotid artery stenosis; PAD, peripheral artery disease; ABI, ankle-brachial index
Figure 4
Figure 4. Multivariate logistic regression analyses of moderate to severe CAS by the degree of PAD severity
CAS, carotid artery stenosis; ABI, ankle-brachial index
See this image and copyright information in PMC

References

    1. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics–2013 update: A report from the american heart association. Circulation. 2013;127:e6–e245. - PMC - PubMed
    1. Berger JS, Hochman J, Lobach I, Adelman MA, Riles TS, Rockman CB. Modifiable risk factor burden and the prevalence of peripheral artery disease in different vascular territories. Journal of vascular surgery. 2013;58:673–681. - PubMed
    1. Golomb BA, Dang TT, Criqui MH. Peripheral arterial disease: Morbidity and mortality implications. Circulation. 2006;114:688–699. - PubMed
    1. Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, et al. Measurement and interpretation of the ankle-brachial index: A scientific statement from the american heart association. Circulation. 2012;126:2890–2909. - PubMed
    1. Zheng ZJ, Sharrett AR, Chambless LE, Rosamond WD, Nieto FJ, Sheps DS, et al. Associations of ankle-brachial index with clinical coronary heart disease, stroke and preclinical carotid and popliteal atherosclerosis: The atherosclerosis risk in communities (aric) study. Atherosclerosis. 1997;131:115–125. - PubMed

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