The Prevalence of Polyvascular Disease in Patients Referred for Peripheral Arterial Disease

Objective: To objectively assess the presence of polyvascular disease in patients with peripheral arterial disease and its relation to inflammation and clinical risk factors. Methods: A total of 431 vascular surgery patients (mean age 68 years, men 77%) with atherosclerotic disease were enrolled. The presence of atherosclerosis was assessed using ultrasonography. Affected territories were defined as: (1) carotid, stenosis of common or internal carotid artery of ≥50%, (2) cardiac, left ventricular wall motion abnormalities, (3) abdominal aorta, diameter ≥30 mm and (4) lower limb, ankle-brachial pressure index <0.9. Cardiovascular risk factors and high-sensitivity C-reactive protein (hs-CRP) levels were noted in all. Results: One vascular territory was affected in 29% of the patients, whereas polyvascular disease was found in 71%: two affected territories in 45%, three in 23% and four in 3% of patients. Levels of hs-CRP increased with the number of affected vascular territories (p < 0.001). Multivariable logistic regression analysis showed age ≥70 years, male gender, body mass index (BMI) ≥ 25 kg m-2, and hs-CRP to be independently associated with polyvascular disease. Conclusion: Polyvascular disease is a common condition in patients who have undergone vascular surgery. The level of systemic inflammation, reflected by hs-CRP levels, is moderately associated with the extent of polyvascular disease.

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