Summary

The aim of this study was to determine whether patients withcoronary artery disease (CAD) and concomitant peripheralarterial disease (PAD) have a greater inflammatory status thanthose with CAD alone. To this aim, we evaluated PAD(ankle/brachial pressure index <0.9), and measured plasmalevels of C-reactive protein (CRP), interleukin-6 (IL-6) and thesoluble forms of intercellular adhesion molecule-1 (sICAM-1)and vascular cell adhesion molecule-1 (sVCAM-1) in 234patients who underwent coronary angiography. Median levels ofCRP, IL-6 and sICAM-1 were higher in the CAD without PAD(n=134) and CAD+PAD (n=40) groups than in 60 patientswithout either disease ("controls"). Median CRP values werehigher in patients with CAD+PAD than in patients with CAD alone (4.7 mg/L [1.5; 7.6] vs 2.4 mg/L [0.9; 3.8], p < 0.01).ThreevesselCAD was diagnosed in 60% of CAD+PAD patients andin 21% (p< 0.01) of CAD only patients. After adjustment forconfounding factors, only PAD was independently associatedwith three-vessel CAD (p<0.001). This association was maintainedafter adjustment for IL-6, the only inflammatory parametersignificantly associated with three-vessel CAD at univariateanalysis (p<0.01). In conclusion, in CAD the coexistence ofPAD is associated with a greater inflammatory status and morewidespread coronary atherosclerosis.These results could helpto explain the high cardiovascular risk of patients with concomitantCAD and PAD and suggest that PAD be included amongthe variables used to identify CAD patients for further diagnosticevaluation.