Peripheral Arterial Disease in Coronary Artery Bypass Graft Candidates: Prevalence, Risk Factors and Functional Mobility

Authors

  • Kamontip Harnphadungkit Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Wilawan Thirapatarapong Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Vareerat Wanichagorn Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Thitima Chanawises Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Pansak Laksanabunsong Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

Keywords:

prevalence, peripheral arterial disease (PAD), coronary artery bypass, ankle brachial index (ABI), mobility, quality of life

Abstract

Objectives: To determine the prevalence of peripheral arterial disease (PAD) among coronary artery bypass graft (CABG) candidates during the preoperative period of their surgical admission using the ankle brachial index (ABI) screening method and to evaluate risk factors, quality of life, and functional mobility.

Study design: Cross-sectional study.

Setting: Siriraj Hospital.

Subjects: Coronary artery bypass candidates.

Methods: Ankle brachial index (ABI) ≤ 0.9 was used to diagnose PAD. The four-meter walk test (4MWT) was used to evaluate functional mobility and the 36-Item Short Form Survey (SF-36) was used to evaluate quality of life.

Results: Of 192 candidates, 143 (74.5%) were male and 49 (25.5%) were female. Mean age was 64 years (SD 10). The prevalence of PAD identified by ABI screening was 12.5%.  However, only 4.2% had a history of PAD.  Age was the only risk factor significantly correlated with coexisting PAD in the CABG candidates. PAD risk was higher in patients of advanced age. There were no statistically significant differences between the PAD and non-PAD groups in calf pain or claudication symptoms, congestive heart failure, foot ulcers, end-stage renal disease (ESRD) or osteoarthritis of knee (OA knee). However, left ven-tricular ejection fraction (LVEF) was lower in the PAD group (mean 46.0, SD 20.9) than the non-PAD group (mean 55.95, SD 17.19) (p = 0.031). Time needed to complete the 4MWT was significantly higher in the PAD group (mean 6.6, SD 2.6 seconds) than non-PAD group (mean 4.9, SD 1.8 seconds) (p = 0.01). SF-36 revealed that the PAD group had a lower quality of life in the physical domain (p = 0.007).

Conclusions: PAD was identified in 12.5% of the CABG candidates. However, most cases were unrecognized. The PAD group had lower LVEF, functional mobility, physical health domain of quality of life than the non-PAD group.

Keywords: prevalence, peripheral arterial disease (PAD), coronary artery bypass, ankle brachial index (ABI), mobility, quality of life

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Published

2021-10-08