Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Arterial Disease of The Leg Frequently Overlooked in Patients with Heart Disease

Peripheral arterial disease (PAD) of the legs, in which the arteries become blocked with plaque and blood supply to the legs is reduced, affects eight million people in the U.S. Early detection of PAD is important because it can limit the ability to walk and exercise, it may place patients at greater risk for limb loss and it increases the chance of having a heart attack or stroke.

Coronary artery disease (CAD) is prevalent in patients with PAD and it is known that PAD is under diagnosed in the primary care setting, but a new study found that it is often overlooked even in patients with known heart disease who are under a cardiologist’s care. The study was published in the May issue of Catheterization and Cardiovascular Interventions, the official journal of The Society for Cardiovascular Angiography and Interventions (SCAI).

Led by Dr. Issam D. Moussa of New York Presbyterian Hospital/Weill Cornell Medical Center, the study involved nearly 800 patients with ischemic heart disease who were to undergo coronary angiography and/or intervention and were either at least 70 years old, or between the ages of 50 and 69 and had a history of diabetes mellitus and/or tobacco use. Researchers determined if patients had PAD by calculating the Ankle-Brachial Index, the ratio of the blood pressure in the lower legs to blood pressure in the arms, which is normally the first test administered to patients in cases where PAD is suspected. Patients also answered questionnaires on PAD awareness and functional status.

The results showed that approximately one out of six patients had previously unrecognized PAD, despite being under the care of a cardiovascular specialist. The researchers point out that this includes only those with previously undiagnosed PAD and does not represent the total prevalence of PAD in patients with heart disease, which is actually much higher. Most patients with PAD did not limp or have leg pain, two symptoms of the disease. “The combination of physician lack of awareness and lack of symptoms among patients results in failure to diagnose PAD, even in patients who are at high risk,” the researchers state. “Furthermore, clinical evaluation alone often lacks the sensitivity and specificity to optimally identify PAD particularly in less advanced stages and in hospitalized patients with CAD.”

The study also found that previously missed PAD was more frequent in older patients and women, which goes against the conventional wisdom that PAD is more prevalent in men and suggests that PAD is more frequently overlooked in women than men in outpatient settings. In addition, the study showed that patients with PAD had a more severe form of CAD, which may account for the worse outcome of heart patients who also have PAD compared to those who do not. The authors note that “making a diagnosis of PAD in a patient with CAD should prompt the clinician to be more aggressive with risk factor intervention, foot protection and a high clinical index of suspicion for progressive PAD symptoms,” adding that these patients should be viewed as exceptionally high risk.

They also note that establishing an early diagnosis of PAD promotes the preservation of functional status in the lower limbs, which is particularly important in patients CAD, since PAD may limit active participation in cardiovascular rehabilitation following coronary interventions. Many physicians cite the lack of space, time and resources as barriers to implementing a systematic PAD screening program, however new guidelines by the American Heart Association and the American College of Cardiology advocate screening for PAD in patients with CAD. The authors conclude that their findings present a compelling argument that screening for PAD should become standard of care in these patients.

This study is published in Catheterization and Cardiovascular Interventions. Media wishing to receive a PDF of this article may contact

Issam D. Moussa, M.D., FSCAI is the Director of Endovascular Services in the Division of Cardiology at New York Presbyterian Hospital/Weill Cornell Medical Center and Associate Professor of Medicine at Weill Medical College of Cornell University in New York. Dr. Moussa can be reached for questions at

The Society for Cardiovascular Angiography and Interventions (SCAI) is the primary professional association for invasive and interventional cardiologists, representing over 4,300 physicians in 60 countries. The Society’s mission is to promote excellence in invasive and interventional cardiovascular medicine through physician education and representation, its monthly journal Catheterization and Cardiovascular Interventions, and the advancement of quality standards to enhance patient care. For more information, please visit or SCAI’s comprehensive patient education website,

Sean Wagner | EurekAlert!
Further information:

More articles from Studies and Analyses:

nachricht Diagnoses: When Are Several Opinions Better Than One?
19.07.2016 | Max-Planck-Institut für Bildungsforschung

nachricht High in calories and low in nutrients when adolescents share pictures of food online
07.04.2016 | University of Gothenburg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

Im Focus: New Products - Highlights of COMPAMED 2016

COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.

In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Oasis of life in the ice-covered central Arctic

24.10.2016 | Earth Sciences

‘Farming’ bacteria to boost growth in the oceans

24.10.2016 | Life Sciences

Light-driven atomic rotations excite magnetic waves

24.10.2016 | Physics and Astronomy

More VideoLinks >>>