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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina


A. Mlaćo, M. Dilić, S. Pehar, O. Terzić, S. Kazić and A. Kurčehajić
Institute of Vascular Diseases, Clinical Center University of Sarajevo, Bosnia and Herzegovina

Background: it is well known that atherosclerosis as systemic disease have a significant correlation with score of multiple risk factors (MRF) and intima-media thickness (IMT) of magistral arteries, i.e. common carotid, brachial, and common femoral. Atherosclerosis as a multifocal disease, produces multisegmental stenotic changes of various arterial segments which arises simultaneously as a pre-existing asymptomatic disease. Aim of this study is to evaluate presence of multifocal atherosclerotic disease among pts. with predominant arterial occlusive disease (AOD), and to correlate arterial hypertension as a major independent risk factor and multifocal atherosclerotic disease. Methods: we included 109 consecutive patients treated at our Institute in the period Dec 1999 - Dec 2000, all with clear arterial occlusive disease (AOD). According to Fontaine clinical staging of their AOD we made three groups - group A, clinical stage II 63 pts, group B, clinical stage III 32 pts, and group C, clinical stage IV 14 pts. We evaluated clnical variables: age, gender, arterial hypertension (HTA), tobacco, hyperlipidemia (HLP), obesity (BMI), diabetes mellitus, coronary heart disease (CHD), and cerebrovascular disease (CVD). Score of MRF is calculated as x/9. Special focus has made to pts. with positive HTA. All pts. were evaluated according to clinical evidence of CHD and CVD, respectively. Results: we had 109 pts, 89 males and 20 females, average age of 62 yrs, males 63 and females 60 yrs. In the A group were 63 pts. with average MRF 4,27, in the B group 32 pts.with MRF 3,97, in the C group 14 pts.with MRF 3,93. Out of total number of pts. 52 were hypertensive (47,7%), 41 males, and 11 females, with average age 64,8 yrs, males, and 61,8 yrs, females. Isolated systolic HTA had 33 pts. (63,5%), and 19 pts.(36,5%) sysotlic and dyastolic HTA. In whole group (n-109), multifocal disease, AOD+CHD, had 30 pts. (MRF score 4,2), AOD+CVD had 14 pts. (MRF score 4,1). In hypertensive pts. multifocal atherosclerotic disease, AOD+CHD, had 15 pts. (29%), while AOD+CVD had 3 pts. (6%), and AOD+CHD+CVD, 2 pts (4%). Among clinical variables, tobacco was of high risk, 97 pts. positive (89,9%), what is of high significance, p<0,0001. Conclusions: we have a clear connection in our group of AOD pts. with elevated MRF score, especially clinical variables, arterial hypertension (p<0,01), and smoking (p<0,0001). Multifocal atherosclerotic disease was present in 44 pts.(40,4%), and among hypertensive pts. multifocal atherosclerotic disease was present in 15 pts.(28,9%). There is a positive correlation rank of multifocal disease and all clinical vaiables, r=.64, and borderline correlation rank of multifocal disease and HTA, r=.37.

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