Peripheral arterial disease in patients with coronary disease: prevalence and prognostic value. The Monica Toulouse register.

Purpose.-This study was aimed at evaluating the prevalence of peripheral ar terial disease of the lower extremities and its prognostic value in a popul ation of patients from the Haute-Garonne department, who were hospitalized for acute coronary artery disease. Methods.-Between 1985 and 1991, four thousands three hundred and sixty-eigh t patients (3,680 males and 688 females) presenting with acute coronary art ery disease were included in the study. Results.-The prevalence of peripheral arterial disease of the lower extremi ties was 13.4%, increasing with age and being higher in male patients. In r egard to patients hospitalized for acute myocardial infarction (n = 2,417), independent relationships were observed between the 28-day mortality and t he following: patient's age (odds ratio: 1.02; 95% confidence interval: 1.0 1-1.04; P < 0.0005), female gender (odds ratio: 1.32; 95% confidence interv al: 1.17-1.54; P < 0.002), inclusion in the study (odds ratio 0.95; 95% con fidence interval: 0.90-0.99; P < 0.02), previous coronary artery disease (o dds ratio: 2.88; 95% confidence interval: 2.32-3.48; P < 0.0001), and perip heral arterial disease (odds ratio: 1.61; 95% confidence interval: 1.26-2.0 6; P < 0.0001). Conclusion.-The prevalence of peripheral arterial disease of the lower extr emities is high in patients with acute coronary artery disease in both gend ers, whatever the age. This disease is therefore an independent marker of m ortality for acute myocardial infarction. Easy diagnosis of peripheral arte rial disease of the lower limbs by measurement of the ankle pressure index allows identification of patients prone to death from acute myocardial infa rction. (C) 1999 Elsevier, Paris.