Published: 2020-01-27

Study prevalence of peripheral arterial disease in diabetics with coronary artery disease at a large tertiary care teaching hospital in North India

Sajad Hussain Bhat, Mohd Yousuf Dar, Aadil Majeed


Background: Peripheral arterial disease and coronary artery disease have similar factors. The extent and severity of PAD is significantly associated with presence and severity of CAD.

Methods: Patients were interviewed and clinical profile of patients including risk factors of coronary artery disease like diabetes, hypertension, smoking, dyslipidemia, obesity and family history of coronary artery disease were assessed and recorded in the proforma. Information regarding demographics, co morbidity, past history and family history was collected. Physical examination of each patient was carried and basic anthropometric data: height, weight, BMI and blood pressure, peripheral pulses calculated. Investigations both non- invasive and invasive including peripheral angiography were recorded.

Results: In this prospective study fifty (50) type 2 diabetes patients admitted with CAD were studied whose mean age was 55.6+8.2 and mean duration of diabetes was 6.8+8.4. In this study none of the patients with PAD had single atherosclerosis risk factors including diabetes. 30% patients were having two risk factors. PAD in in patients with CAD is particularly enhanced by the concomitant occurrence of two or more of these risk factors (p=0.016). Hypertension as a predictor of PAD was statistically significant (p=0.0037). In this study the duration of diabetes was <5 years in 10%, 5-10 years in 40% and >10 years in 40% of patients with angiographically proven PAD.

Conclusions: It was observed that presence and severity CAD was significantly associated with PAD.


Ankle brachial index, Body mass index, Coronary artery bypass graft, Coronary artery disease, Percutaneous intervention, Peripheral arterial disease

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Jude EB Oyibo SO, Chambers N, Boultan AJ. Peripheral arterial disease in diabetic and non- diabetic patients: a comparison of severity and outcome, Diab Care. 2001.24:1433-137.

Christlieb A R: Diabetes and hypertensive vascular disease. Mechanism and treatment. Am J Cardio. 1973;32:592-606.

Viles- Gonzalez JF, Fuster V, Badimon JJ. Atherothrombosis: a widespread disease with unpredictable and life threatning consequences. Eur Heart J. 2004;25:1197-207.

Nathaniel Clark MD MS RD: American Diabetes Association Beauregard St. Alexandaria, VA. 2003;223(11):1701.

Beckman JA, Creager MA, Libby P: Diabetes and Atherosclerosis: epidemilogy, pathphysiology and management. JAMA. 2002;287:2570-81.

Fowkes FG, Housley E, Cawood EH, Macintyre CC, Ruckley CV, Prescott RJ. Edinburgh Artery Study: prevalence of asymptomatic and symptomatic peripheral arterial disease in the genral population. Int J Epidemiol. 1991;20:384-92.

Meijer WT, Hoes AW, Rutgers D, Bots ML, Hofman A, Grobee DE. Peripheral arterial disease in the elderly. Roterdam Study Arterioscl Thumb Vasc Biol. 1998;185-92.

Allison MA, Criqui MH, McClelland RL, Scott JM, McDermott MM, Liu K, et al. The effect of novel cardiovascular risk factors on the ethnic-specific odds for peripheral arterial disease in the Multi-Ethnic Study of Atherosclerosis (MESA). Journal of the Am Coll Cardiol. 2006 Sep 19;48(6):1190-7.

Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the united states: results from the national health and nutrition examination survey, 1999-2000. Circulation. 2004;110:738-43.

Morales DD, Punzalan FE, Paz-Pacheco E, Sy RG, Duante CA. Metabolic syndrome in the Philippine general population: prevalence and risk for atherosclerotic cardiovascular disease and diabetes mellitus. Diabe Vasc Dis Res. 2008 Mar;5(1):36-43.

MacGregor AS, Price JF, Hau CM, Lee AJ, Carson MN, Fowkes FG. Role of systolic blood pressure and plasma triglycerides in diabetic peripheral arterial disease. Diab care. 1999 Mar 1;22(3):453-8.

Kallio M, Forsblom C, Groop PH, Groop L, Lepäntalo M. Development of new peripheral arterial occlusive disease in patients with type 2 diabetes during a mean follow-up of 11 years. Care. 2003 Apr 1;26(4):1241-5.

Kannel WB, Skinner JR JJ, Schwartz MJ, Shurtleff D. Intermittent claudication: incidence in the Framingham Study. Circulation. 1970 May;41(5):875-83.

Siddiqi RO, Paracha MI, Hammad M. Frequency of peripheral arterial disease in patients presenting with acute coronary syndrome at a tertiary care centre in Karachi. JPMA. Jthe Pakistan Med Assoc. 2010 Mar 1;60(3):171.

Agarwal AK, Singh M, Arya V. Prevalence of peripheral arteial disease in type 2 diabetes milletus and its correlation with coronary arterial disease and its risk factors. JAPI. 2012;60:27-32.

Kotwal A, Sharma R, Abrol S, Badgal A. A study of risk factor stratification in patients of coronary artery disease with concomitant peripheral arterial disease. Sch J App Med Sci, 2015;3(1E):359-62.

Rigatelli G, Rigatelli G. Screening of peripheral vascular disease in patients facing coronary surgery: is invasive angiography really out?. Annal Thoracic Surg. 2005 Aug 1;80(2):788-9.

Li J, Luo Y, Xu Y, Yang J, Zheng L, Hasimu B, et al. Risk factors of peripheral arterial disease and relationship between low ankle-brachial index and mortality from all-cause and cardiovascular disease in Chinese patients with type 2 diabetes. Circulation J. 2007;71(3):377-81.

Janka HU, Standl E, Mehnert H. Peripheral vascular disease in diabetes mellitus and its relation to cardiovascular risk factors: screening with the Doppler ultrasonic technique. Diab care. 1980 Mar 1;3(2):207-13.