Prognostic significance of atherosclerosis of one or two vascular systems in patients with high and very high cardiovascular risk
Open Access
- 28 March 2021
- journal article
- Published by Silicea - Poligraf, LLC in Cardiovascular Therapy and Prevention
- Vol. 20 (2), 2669
- https://doi.org/10.15829/1728-8800-2021-2669
Abstract
Aim.To study the prognostic significance of atherosclerosis of one and several vascular systems in patients with high and very high cardiovascular risk (CVR).Material and methods. The study included 171 patients with high (26,9%) and very high (73,1%) CVR. All patients underwent duplex ultrasound of the carotid and lower limb arteries. The composite endpoint (CE) was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and coronary revascularization.Results.The follow-up period lasted 31,1 (17,8; 47,9) months. CE events occurred in 29 (16,9%) patients: cardiovascular death — 3 (1,75%) patients; nonfatal myocardial infarction — 7 (4,09%) patients; nonfatal stroke — 6 (3,51%) patients; coronary revascularization — 13 (7,60%) patients. Cumulative survival of patients with high and very high CVR with atherosclerotic plaques in the same vascular system did not significantly differ from that in patients with intact peripheral arteries (p=0,977). The event-free survival of patients with combined lesions of the carotid and lower limb arteries was significantly lower in comparison with patients with one vascular system involvement (p=0,011). The combined lesion of the carotid and lower limb arteries was associated with an increase in the relative risk (RR) of adverse cardiovascular events (RR, 3,15 (95% CI, 1,02-9,74; p=0,046), adjusted for sex, age, and peripheral arterial disease symptoms.Conclusion.In patients with high and very high CVR, atherosclerotic lesion of two vascular systems of peripheral arteries is associated with an increase in the RR of adverse cardiovascular events, adjusted for sex, age, and peripheral arterial disease symptoms. The presence of atherosclerotic plaques in one vascular bed was not associated with an increase in the risk of CE events.Keywords
This publication has 23 references indexed in Scilit:
- Polyvascular disease and risk: When two is not better than oneVascular Medicine, 2018
- Focus on echovascular imaging assessment of arterial disease: complement to the ESC guidelines (PARTIM 1) in collaboration with the Working Group on Aorta and Peripheral Vascular DiseasesEuropean Heart Journal – Cardiovascular Imaging, 2018
- ULTRASOUND MARKERS OF PREMANIFEST ATHEROSCLEROSIS OF CAROTID AND FEMORAL ARTERIES IN ASSESSMENT OF CARDIOVASCULAR RISKRussian Journal of Cardiology, 2018
- CARDIOVASCULAR PREVENTION 2017. NATIONAL GUIDELINESRussian Journal of Cardiology, 2018
- Incremental prognostic value of coronary and systemic atherosclerosis after myocardial infarctionInternational Journal of Cardiology, 2018
- Prevalence of Carotid Plaque in a 63‐ to 65‐Year‐Old Norwegian Cohort From the General Population: The ACE (Akershus Cardiac Examination) 1950 StudyJournal of the American Heart Association, 2018
- ‘Highest risk–highest benefit’ strategy: a pragmatic, cost-effective approach to targeting use of PCSK9 inhibitor therapiesEuropean Heart Journal, 2017
- 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)European Heart Journal, 2017
- Prognostic impact of subclinical or manifest extracoronary artery diseases after acute myocardial infarctionAtherosclerosis, 2017
- Asymptomatic polyvascular disease and the risks of cardiovascular events and all-cause deathAtherosclerosis, 2017