Peculiarities of polyvascular disease and the diagnostic significance of the ankle-brachial index in patients with coronary artery disease: results from the real-world registry KAMMA (Clinical registry on patient population with polyvascular disease in the Russian Federation and Eurasian countries)
G. P. Arutyunov,
E. I. Tarlovskaya,
A. G. Arutyunov,
T. I. Batluk,
N. A. Koziolova,
A. I. Chesnikova,
A. Y. Vaskin,
D. S. Tokmin,
I. G. Bakulin,
O. L. Barbarash,
N. U. Grigoryeva,
I. V. Gubareva,
N. V. Izmozherova,
U. K. Kamilova,
S. G. Kechedzhieva,
Z. F. Kim,
N. A. Koriagina,
S. V. Mironova,
N. P. Mitkovskaya,
S. V. Nemirova,
L. M. Nurieva,
M. M. Petrova,
E. A. Polyanskaya,
A. P. Rebrov,
A. V. Svarovskaya,
E. A. Smirnova,
A. B. Sugraliev,
Y. B. Khovaeva,
G. V. Shavkuta,
I. I. Shaposhnik,
M. Y. Alieva,
A. B. Almukhanova,
A. V. Aparkina,
R. A. Bashkinov,
L. N. Belousova,
E. I. Blokhina,
V. O. Bochkareva,
M. V. Buianova,
F. Y. Valikulova,
A. D. Vende,
A. S. Galyavich,
V. V. Genkel,
E. V. Gorbunova,
E. D. Gordeychuk,
E. A. Grigorenko,
E. V. Grigoryeva,
I. L. Davydkin,
D. S. Evdokimov,
A. N. Ermilova,
S. B. Zhangelova,
N. V. Zhdankina,
E. I. Zheleznyak,
N. S. Ilyanok,
D. A. Kapsultanova,
N. A. Karoli,
E. A. Kartashova,
A. S. Kuznetsova,
A. T. Kumaritova,
N. A. Magdeeva,
S. A. Makarov,
E. S. Melnikov,
M. V. Novikova,
I. A. Obukhova,
E. V. Ponomarenko,
A. O. Rubanenko,
O. A. Rubanenko,
F. E. Rustamova,
V. A. Safronenko,
E. I. Suchkova,
A. I. Sycheva,
D. R. Tagaeva,
M. A. Trubnikova,
T. P. Trunina,
A. G. Frolov,
V. V. Khatlamadzhiyan,
Y. I. Khokhlova,
A. I. Chernyavina,
O. Y. Chizhova,
M. A. Shambatov,
T. V. Shnyukova,
Y. V. Shchukin https://doi.org/10.15829/1560-4071-2024-5837
EDN: AZMGQZ
Abstract
Aim. To investigate the prevalence and characteristics of polyvascular disease in the Eurasian region's population with one or more previously established locations of atherosclerotic arterial damage, and to evaluate the diagnostic importance of the ankle-brachial index (ABI) as a marker for polyvascular disease (PVD).
Material and methods. A total of 1837 patients were included in the main branch of the KAMMA registry (patients with PVD), among which 91,6% had coronary artery disease (CAD) (n=1683). For further analysis, the group of patients with CAD was combined with 1222 patients included in the second branch of the registry — KAMMA-cardio, forming a patient population (n=2905), in which all patients had verified CAD. The mean age of patients was 66,0 [59,0; 72,0] years, with 60,3% being male. Peripheral arteries was assessed using ultrasound examination.
Results. PVD was present in 95,6% of patients with coronary atherosclerosis: dual-region involvement was observed in 51,3% of patients, three-region involvement in 37,1%, four-region involvement in 3,4%, and five-region involvement in 2,0%. Stenoses of the common carotid artery were observed in 71% of patients, internal carotid artery — in 68%, lower limb artery — in 52%, and renal and mesenteric artery — in 8,3%. There were following diagnostic effectiveness of the ABI for detecting patients with lower limb artery stenosis was: sensitivity — 58,0%, specificity — 83,6%. The quality of antithrombotic and lipid-lowering therapy was insufficient.
Conclusion. In the overwhelming majority (95,6%) of patients with CAD in the KAMMA registry, PVD was revealed, with nearly half of the patients having involvement in three or more arterial zones. In the patient population with CAD, there should be an active effort to identify patients with PVD, using at least the ABI determination and active modern antithrombotic and lipid-lowering therapy according to current clinical guidelines.
About the Authors
G. P. Arutyunov
Eurasian Association of Internal Medicine; Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
None
E. I. Tarlovskaya
Eurasian Association of Internal Medicine; Privolzhsky Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Moscow; Nizhny Novgorod
Competing Interests:
None
A. G. Arutyunov
Eurasian Association of Internal Medicine; S. Avdalbekyan National Institute of Health
Armenia
Competing Interests:
Armenia
Moscow; Yerevan
Competing Interests:
None
T. I. Batluk
Eurasian Association of Internal Medicine
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
None
N. A. Koziolova
E.A. Wagner Perm State Medical University
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
None
A. I. Chesnikova
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
None
A. Y. Vaskin
Eurasian Association of Internal Medicine
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
None
D. S. Tokmin
Alphastat Analytics Agency
Russian Federation
Competing Interests:
Russian Federation
Angarsk
Competing Interests:
None
I. G. Bakulin
I.I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
Saint-Petersburg
Competing Interests:
None
O. L. Barbarash
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Competing Interests:
Russian Federation
Kemerovo
Competing Interests:
None
N. U. Grigoryeva
Lobachevsky National Research University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
None
I. V. Gubareva
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Samara
Competing Interests:
None
N. V. Izmozherova
Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Yekaterinburg
Competing Interests:
None
U. K. Kamilova
Republican Specialized Scientific and Practical Medical Center of Therapy and Medical Rehabilitation
Uzbekistan
Competing Interests:
Uzbekistan
Tashkent
Competing Interests:
None
S. G. Kechedzhieva
Stavropol State Medical University
Russian Federation
Competing Interests:
Russian Federation
Stavropol
Competing Interests:
None
Z. F. Kim
Kazan State Medical University; City Clinical Hospital № 7
Russian Federation
Competing Interests:
Russian Federation
Kazan
Competing Interests:
None
N. A. Koriagina
E.A. Wagner Perm State Medical University; LLC "Women's Health Clinic"
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
None
S. V. Mironova
Perm Regional Hospital for Veterans War
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
None
N. P. Mitkovskaya
Republican Scientific and Practical Center of Cardiology
Belarus
Competing Interests:
Belarus
Minsk
Competing Interests:
None
S. V. Nemirova
Privolzhsky Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
None
L. M. Nurieva
City Clinical Hospital № 7
Russian Federation
Competing Interests:
Russian Federation
Kazan
Competing Interests:
None
M. M. Petrova
N.S. Karpovich Krasnoyarsk Interdistrict Clinical Emergency Hospital
Russian Federation
Competing Interests:
Russian Federation
Krasnoyarsk
Competing Interests:
None
E. A. Polyanskaya
E.A. Wagner Perm State Medical University
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
None
A. P. Rebrov
V.I. Razumovskiy Saratov State Medical University; Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Saratov
Competing Interests:
None
A. V. Svarovskaya
Cardiology Research Institute; Tomsk National Research Medical Center
Russian Federation
Competing Interests:
Russian Federation
Tomsk
Competing Interests:
None
E. A. Smirnova
I.P. Pavlov Ryazan State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ryazan
Competing Interests:
None
A. B. Sugraliev
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
None
Y. B. Khovaeva
F.C. Gral City Clinical Hospital № 2
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
None
G. V. Shavkuta
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
None
I. I. Shaposhnik
South-Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Chelyabinsk
Competing Interests:
None
M. Y. Alieva
Republican Specialized Scientific and Practical Medical Center of Therapy and Medical Rehabilitation
Uzbekistan
Competing Interests:
Uzbekistan
Tashkent
Competing Interests:
None
A. B. Almukhanova
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
None
A. V. Aparkina
V.I. Razumovskiy Saratov State Medical University; Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Saratov
Competing Interests:
None
R. A. Bashkinov
Eurasian Association of Internal Medicine; I.I. Mechnicov North-Western State Medical University; Clinical Rheumatology Hospital № 25
Russian Federation
Competing Interests:
Russian Federation
Moscow; Saint-Petersburg
Competing Interests:
None
L. N. Belousova
I.I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
Saint-Petersburg
Competing Interests:
None
E. I. Blokhina
Lobachevsky National Research University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
None
V. O. Bochkareva
N.S. Karpovich Krasnoyarsk Interdistrict Clinical Emergency Hospital
Russian Federation
Competing Interests:
Russian Federation
Krasnoyarsk
Competing Interests:
None
M. V. Buianova
Lobachevsky National Research University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
None
F. Y. Valikulova
Privolzhsky Research Medical University; City Polyclinic № 31 of Sovetsky District
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
None
A. D. Vende
Cardiology Research Institute; Tomsk National Research Medical Center
Russian Federation
Competing Interests:
Russian Federation
Tomsk
Competing Interests:
None
A. S. Galyavich
Kazan State Medical University
Russian Federation
Competing Interests:
Russian Federation
Kazan
Competing Interests:
None
V. V. Genkel
South-Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Chelyabinsk
Competing Interests:
None
E. V. Gorbunova
Research Institute for Complex Issues of Cardiovascular Diseases; L.S. Barbarash Kuzbass Clinical Cardiology Dispensary
Russian Federation
Competing Interests:
Russian Federation
Kemerovo
Competing Interests:
None
E. D. Gordeychuk
Eurasian Association of Internal Medicine; Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
None
E. A. Grigorenko
Republican Scientific and Practical Center of Cardiology
Belarus
Competing Interests:
Belarus
Minsk
Competing Interests:
None
E. V. Grigoryeva
V.I. Razumovskiy Saratov State Medical University; Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Saratov
Competing Interests:
None
I. L. Davydkin
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Samara
Competing Interests:
None
D. S. Evdokimov
I.I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
Saint-Petersburg
Competing Interests:
None
A. N. Ermilova
Eurasian Association of Internal Medicine; Fomin's Сlinic Michurinsky; Fomin's Сlinic Dolgorukovskaya
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
None
S. B. Zhangelova
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
None
N. V. Zhdankina
Lobachevsky National Research University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
None
E. I. Zheleznyak
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
None
N. S. Ilyanok
I.P. Pavlov Ryazan State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ryazan
Competing Interests:
None
D. A. Kapsultanova
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
None
N. A. Karoli
V.I. Razumovskiy Saratov State Medical University; Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Saratov
Competing Interests:
None
E. A. Kartashova
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
None
A. S. Kuznetsova
South-Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Chelyabinsk
Competing Interests:
None
A. T. Kumaritova
I.I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
Saint-Petersburg
Competing Interests:
None
N. A. Magdeeva
V.I. Razumovskiy Saratov State Medical University; Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Saratov
Competing Interests:
None
S. A. Makarov
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Competing Interests:
Russian Federation
Kemerovo
Competing Interests:
None
E. S. Melnikov
Eurasian Association of Internal Medicine; I.I. Mechnicov North-Western State Medical University; Clinical Rheumatology Hospital № 25
Russian Federation
Competing Interests:
Russian Federation
Moscow; Saint-Petersburg
Competing Interests:
None
M. V. Novikova
Stavropol Regional Cardiology Center
Russian Federation
Competing Interests:
Russian Federation
Stavropol
Competing Interests:
None
I. A. Obukhova
N.S. Karpovich Krasnoyarsk Interdistrict Clinical Emergency Hospital
Russian Federation
Competing Interests:
Russian Federation
Krasnoyarsk
Competing Interests:
None
E. V. Ponomarenko
Health Formula
Russian Federation
Competing Interests:
Russian Federation
Krasnodar
Competing Interests:
None
A. O. Rubanenko
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Samara
Competing Interests:
None
O. A. Rubanenko
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Samara
Competing Interests:
None
F. E. Rustamova
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
None
V. A. Safronenko
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
None
E. I. Suchkova
I.P. Pavlov Ryazan State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ryazan
Competing Interests:
None
A. I. Sycheva
F.C. Gral City Clinical Hospital № 2
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
None
D. R. Tagaeva
Republican Specialized Scientific and Practical Medical Center of Therapy and Medical Rehabilitation
Uzbekistan
Competing Interests:
Uzbekistan
Tashkent
Competing Interests:
None
M. A. Trubnikova
Eurasian Association of Internal Medicine; Dr. Fomin's Clinic
Russian Federation
Competing Interests:
Russian Federation
Moscow; Sochi
Competing Interests:
None
T. P. Trunina
I.P. Pavlov Ryazan State Medical University; City Clinical Hospital № 11
Russian Federation
Competing Interests:
Russian Federation
Ryazan
Competing Interests:
None
A. G. Frolov
Lobachevsky National Research University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
None
V. V. Khatlamadzhiyan
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
None
Y. I. Khokhlova
I.I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
Saint-Petersburg
Competing Interests:
None
A. I. Chernyavina
Perm Regional Hospital for Veterans War
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
None
O. Y. Chizhova
I.I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
Saint-Petersburg
Competing Interests:
None
M. A. Shambatov
Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Yekaterinburg
Competing Interests:
None
T. V. Shnyukova
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
None
Y. V. Shchukin
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Samara
Competing Interests:
None
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Supplementary files
- 95,6% of patients with coronary artery disease have atherosclerosis involving different locations, and nearly half of them — three or more zones, the most common of which are the common and internal carotid arteries and arterial lesions of the extremities.
- 72,8% of individuals with polyvascular disease experienced major cardiovascular events, including myocardial infarction, ischemic stroke, and transient ischemic attack.
- Despite the very high cardiovascular risk in patients with coronary artery disease and polyvascular disease, the quality of antithrombotic and hypolipidemic therapy is insufficient.
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