Prevalence and Risk Factors of Extra-Coronary Atherosclerotic Disease in Patients with Confirmed Coronary Artery Disease: A Cross-Sectional Study in Abidjan Heart Institute

Data on extracoronary atherosclerotic disease in patients with known coronary heart disease (CAD) are scarce in our pratice. Our study aimed to assess the prevalence of carotid atherosclerosis and peripheral artery disease and predictors for extracoronary artery disease in the presence of CAD. From March 1 to October 30, 2018, we conducted a cross-sectional study carried out among 112 patients with confirmed CAD who underwent coronary angiography in the catheterization laboratory of Abidjan Heart Institute. Ultrasound exploration of supra-aortic vessels and lower limbs arteries, and ankle brachial index (ABI) test were performed. The mean age was 57.4 ± 10.9 years old. There was a male predominance (sex ratio = 5). Increased intima media thickness (IMT) was reported in 55.4% of patients. Carotid plaques were observed in about 30% of cases. Smoking (HR = 3.6, P = 0.013) and multivessel CAD (HR = 2.2, P = 0.048) were the main factors associated with increased IMT. Predictive factors for increased IMT and the presence of carotid plaques were male sex (OR = 8.8, P = 0.038), smoking (OR = 2.5, P = 0.049), and multivessel CAD (HR = 3.2, P = 0.014). Concerning lower limbs arteries, 19.8% of patients had at least one plaque in common femoral arteries. Decreased ABI was reported in 48.5% of patients. The main factors associated with decreased ABI were age ≥ 50 years old (HR = 2.6, P = 0.043), diabetes (HR = 2.8, P = 0.02), dyslipidemia (HR = 3.8, P = 0.001) and multi-vessel CAD (HR = 4.5, P < 0.0001). In multivariate analysis, only dyslipidemia (HR = 4.4 P = 0.003) and multi-vessel CAD (HR = 6.3 P < 0.001) were associated with decreased ABI. Coronary artery disease is associated with increased IMT, carotid plaque, and decreased ABI, especially in patients with multivessel CAD. Systematic assessment of extracoronary artery disease should help improve the management of these high-risk patients.