Asymptomatic coronary artery disease in patients with symtomatic peripheral vascular disease detected by Dobutamine stress echo and coronary angiography.
Passey, R.; Mehta, A.; Parikh, R.; Aggrawal, S.; Gupta, A.; Mohan, R.; Sachdeva, S.; Dhawan, S.; Mantri, R.R.; Sawhney, J.P.S.; Chopra, V.K.; Gupta, M.P. and Khanna, P.K. (2002) Asymptomatic coronary artery disease in patients with symtomatic peripheral vascular disease detected by Dobutamine stress echo and coronary angiography. Supplement to the Journal of the American College of Cardiology, 39 (9). 26b.
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Total of 186 patients with symptomatic peripheral vascular disease- PVD (Carotid / Aorto- illio -femoral disease) were evaluated at our center over past 24 months. 64 had history of CAD and underwent coronary along with peripheral angiography. 122 patients with PVD but no history of CAD were evaluated by dobutamine stress echo for CAD. These included 76 smokers, 44 diabetics, 58 hypertensive and 32 patients who had dyslipidemia. Dobutamine stress-echo was performed using incremental doses of 5-30 microgm/kg/min of dobutamine. The end points of the test were appearance of regional wall motion abnormality, angina and target heart rate. Echo images were obtained at baseline, low dose, peak dose and recovery in all four views. Each stage was analyzed for RWMA using 16-segment model. Dobutamine stress echo was positive in 69 cases. These patients underwent coronary along with peripheral angiogram. The coronary profile was LMCA lesions (more than 50%) were -7, triple vessel disease 29, 2-vessel disease -14, single vessel disease 13. Insignificant coronary artery disease or normal -6. In conclusion significant coronary arteries disease was noted in (63/122) 51% of asymptomatic patients with peripheral vascular disease evaluated by Dobutamine stress echo and coronary angiography. We recommend that all patients with peripheral vascular disease should be evaluated with Dobutamine Stress echo and if positive, coronary angiography should be done to detect significant coronary artery disease.
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