The Impact of Chronic Repetitive Leg Ischemia on Left Ventricular Function and Severity of Coronary Atherosclerosis in Patients with Acute Coronary Syndrome
Objective: The purpose of this study was to assess the impact of the presence of peripheral arterial disease (PAD) on left ventricular (LV) function in patients with coronary artery disease (CAD) presenting with acute coronary syndrome (ACS). Subjects and Methods: The medical records of the patients who were referred to Ankara Bayindir Hospital, Ankara, Turkey, due to a first episode of ACS were reviewed. Patients with concomitant PAD and CAD (group 1) were compared with those who had CAD only (group 2). The Mann-Whitney U and χ2 tests were used to compare continuous and categorical variables, respectively. Results: Baseline demographic data of 53 patients with PAD + CAD (42 men and 11 women; mean age 62.5 ± 9.5 years) and a group of 60 patients with CAD only (41 men and 19 women; mean age 59.9 ± 9.8 years) were similar, except for the serum creatinine level which was higher in group 1 than in group 2 (1.32 ± 0.34 vs. 1.03 ± 0.22 mg/dL, p < 0.001). Patients with CAD + PAD had significantly higher Gensini scores (62.6 ± 19.7 vs. 41.4 ± 26.8, p = 0.004) and more 3-vessel disease than patients with CAD alone (62.2 vs. 31.6%, p < 0.045). There was a significant difference between the 2 groups regarding the LV ejection fraction at the time of the diagnosis (52.0 ± 8.2% in the CAD + PAD group and 43.7 ± 13.3% in the CAD-alone group; p = 0.017). Conclusion: CAD concomitant with PAD was associated with preserved LV function at early stages of diagnosis in patients with ACS.