lower extremity arterial calcification as a predictor of coronary atherosclerosis in patients with peripheral arterial disease

Background: until now, there has been no study on the relationship between the calcification of the lower extremity arteries and significant coronary arterial disease (cad). objectives: to evaluate whether lower extremity calcium scores (lecs) are associated with cad and whether this can predict multivessel-cad in patients with peripheral arterial disease (pad). patients and methods: we retrospectively enrolled 103 pad patients without cardiac symptoms or known cad. all patients underwent cardiac computed tomography (ct) and lower extremity ct within 1 month and were categorized as nonsignificant cad, single-cad, or multivessel-cad. the coronary calcium scores (ccs) were quantitatively measured according to the agatston method and lecs were semi-quantitatively measured according to the presence of lower extremity calcification in the segment. the extent of cad was evaluated according to the presence of ≥ 50% luminal diameter stenosis in the segment of cad. results: lecs in multivessel-cad were significantly higher than those in nonsignificant cad (10.0±5.8 versus 4.0±3.1, p < 0.001). lecs significantly correlated with ccs (r = 0.831, p < 0.001) and the extent of cad (r = 0.631, p < 0.001). multivariate regression analysis demonstrated lecs and log-transformed ccs were independent predictors for multivessel-cad. in receiver operating characteristic curve analysis, the diagnostic performance of lecs was 0.807 (95% confidence interval = 0.724-0.891, p < 0.001) for predicting multivessel-cad. conclusion: peripheral arterial calcification is significantly correlated with cad extent in patients with pad. peripheral arterial calcification can be a useful marker for predicting multivessel-cad.