Ultrasonographic evaluation of the morphologic changes of peripheral arteries in patients with coronary atherosclerosis
Atherosclerosis is a multifocal disease leading to construction and thrombosis of arteries in different vascular pools. Two of the major manifestations of the atherosclerosis are PAOD (peripheral artery obstruction disease) and CAD (coronary artery disease). Objective of this clinical study is to establish atherosclerotic changes in lower extremity arteries in patients with CAD 239 participants were examined at the age of 41 to 74 nd were divided in 2 groups. The first group included 102 patients (52 men, 50 women, average age 59.3 years) all of them healthy coronary patients. The 2nd group included 137 patient (89 men, 48 women, average age 60.1 years ) with stable angina pectoris (SAP). In all of the included patients basic demographic characteristics and cardiovascular risk were determined. Doppler Sonography was used to determine ABI index (ankle-brachial) by standard method. Duplex Sonography was used to examine intima media thickness (IMT) and the presence of the atherosclerotic plaques in the bifurcation of the common femoral artery. In the SAP group, statistically, a significantly higher presence of the basic risk factors for atherosclerosis was determined in comparison to the control group. Statistically, patients with SAP have signifi cantly (<0.001) higher average value of IMTCFA (0.76 ± 0.16) compared to the control group (0.49 ± 0.10). Atherosclerotic plaques in CFA (common femoral artery) were found in the majority of the SAP patients (66.68%) while in the group of coronary healthy patients only 7.5 % (p<0.001) were determined. It was also verified that the value of the ABI index in the CAD patients, statistically, is significantly lower (0.88 ± 9.16) compared to the control group (1.01 ± 0.07) andit is below normal reference range which shows higher impact on the lower extremity arteries by atherosclerosis in the SAP patients, when compared to the control group. In the group with SAP , PAOD was diagnosed in 35.8% of the patiens comaped to the control group (13.7%), (p< 0.05). The large number of CAD patients who display atherosclerotic plaques in CFA and growth of the IMTCFA value in comparison to the control group, leads to the conclusion that this is a unified atherosclerotic process developing simultaneously in two vascular pools (coronary and peripheral) revealing itself, through time, by different clinical manifestations. Atherosclerosis is a systematic disease affecting arteries of different vascular pools. Providing systematic screening of the atherosclerosis is important because it aims for an early detection of preclinical and clinical manifestation, prevention and administering therapy before serious organ damage and permanent invalidism of the patients set in.
Key words: ANKLE-BRACHIAL INDEX. ISHEMIC HEART DISEASE. PERIPHERAL ARTERY OBSTRUCTION DESEASE