Polyvascular Disease in the Gulf Region: Concealed Marker of Poor Outcomes in Acute Coronary Syndrome

Abstract

Polyvascular disease (PolyVD) is the presence of atherosclerosis in multiple vascular territories and is associated with an increased risk of major adverse cardiac and cerebrovascular events (MACCE). Our study aims to draw attention to the prevalence and outcomes of PolyVD in patients presenting with acute coronary syndrome (ACS) in the Gulf region. Highlighting the disease burden of PolyVD in our population will lead to more vigilant surveillance, better clinical outcomes, and improved quality of life. Data from 685 adults who presented with ACS from January 2015 to June 2020 was reviewed retrospectively. We evaluated lower extremity artery disease (LEAD) and cerebrovascular disease (CVD) using ABI and carotid duplex. Thirty-five percent (n = 238) of patients had PolyVD. 70% patients with LEAD and 65% patients with CVD were asymptomatic. PolyVD was associated with an increased likelihood (aOR,1.69 [1.02-2.81]; P = 0.03) of MACCE at 1-year. Since the progression of atherosclerosis is an insidious process, most patients remain asymptomatic before presenting with fatal vascular events.