[Clinical and biochemical parameters of patients with vascular stenosis in the lower extremities in the stage of intermittent claudication]

Abstract

Clinical and biochemical parameters obtained by complex investigation of 100 patients suffering from intermittent claudication are presented by the authors. After taking the family and case history, we examined the patients and took laboratory tests including several lipid components, blood clotting factors and parameters influencing blood viscosity. The severity of peripheral vascular disease was defined by ankle/arm ratio, carotid arteries were studied by duplex sonography, coronary circulation was examined by ECG, exercise ECG and Thallium-201 isotopic myocardium scintigraphy. In conjunction with lower extremity vascular disease internal carotid stenosis was diagnosed in 62% and coronary stenosis in 52% of cases examined. In 35% all three regions were affected. The degree of carotid stenosis showed a strong correlation to the severity of the claudication, while in case of the coronary disease there was no connection proved, in spite of its high prevalence. Among the risk factors smoking was present in 89%, hypercholesterolaemia in 84%, hypertension in 54%, diabetes mellitus in 13%, impaired glucose tolerance in 42% and positive family history in 39% of cases. Smoking and accumulation of the risk factors showed correlation to the severity of the lower extremity vessel stenosis, while hypertension and carbohydrate metabolism disturbances showed significant correlations to the degree of carotid stenosis. From different lipid parameters only the cholesterol/HDL-cholesterol ratio showed significant correlation to the severity of the arteriosclerosis. The authors refer to intermittent claudication as the risk factor for carotid and coronary disease. They suggest the assessment of the cerebrovascular and cardiac risk in the patients. This way the optimal order of operative and/or non-operative therapy can be realized.