{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:14:58Z","timestamp":1761844498057},"reference-count":40,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,6,29]],"date-time":"2015-06-29T00:00:00Z","timestamp":1435536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Atherosclerosis is a systemic disease and coronary artery disease is frequently associated with peripheral artery disease. As aortic and mitral valvular calcification (<jats:styled-content style=\"fixed-case\">VC<\/jats:styled-content>) share some etiopathogenetic mechanisms with atherosclerosis, we analyzed the risk profile and the echocardiographic characteristics of patients admitted for first acute coronary syndrome (<jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content>) to investigate whether the presence of <jats:styled-content style=\"fixed-case\">VC<\/jats:styled-content> could be a marker of asymptomatic hemodynamically significant peripheral atherosclerosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 151 patients admitted for <jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content> without previous history of cardiovascular disease were consecutively enrolled. The presence of <jats:styled-content style=\"fixed-case\">VC<\/jats:styled-content> was identified by echocardiography; a carotid stenosis \u226550% by ultrasound identified carotid artery disease (Car<jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>); an ankle\u2013brachial index \u22640.9 or \u22651.4 identified lower extremity artery disease (<jats:styled-content style=\"fixed-case\">LEAD<\/jats:styled-content>). Significant peripheral atherosclerosis was defined by the presence of Car<jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> and\/or <jats:styled-content style=\"fixed-case\">LEAD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Peripheral atherosclerosis was diagnosed in 82 (54.3%) patients; isolated Car<jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> in 24, isolated <jats:styled-content style=\"fixed-case\">LEAD<\/jats:styled-content> in 20, both diseases in 38 patients. <jats:styled-content style=\"fixed-case\">VC<\/jats:styled-content> was present in 103 (68.2%) patients. By multivariate analysis, age (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.059, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.007\u20131.113, P\u00a0=\u00a00.025), diabetes mellitus (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a05.068, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.480\u201317.351, P\u00a0=\u00a00.010), <jats:styled-content style=\"fixed-case\">VC<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a07.422, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.421\u201322.880, P\u00a0&lt;\u00a00.001), and multivessel <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a03.317, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.281\u20138.586, P\u00a0=\u00a00.013) were the only independent predictors of having peripheral atherosclerosis. C\u2010statistic for <jats:styled-content style=\"fixed-case\">VC<\/jats:styled-content> was not inferior to that obtained by age (0.728, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.649\u20130.797 vs. 0.800, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.727\u20130.861, P\u00a0=\u00a00.101) and to that obtained by the combination of multivessel <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> with diabetes (0.750; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.673\u20130.817, P\u00a0=\u00a00.635), and, furthermore, it was higher than that obtained by diabetes alone (0.620, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.538\u20130.698, P\u00a0=\u00a00.036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ruling out the presence of significant peripheral atherosclerosis should be routinely considered in patients with <jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content> showing <jats:styled-content style=\"fixed-case\">VC<\/jats:styled-content> at echocardiography.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13006","type":"journal-article","created":{"date-parts":[[2015,6,30]],"date-time":"2015-06-30T05:11:13Z","timestamp":1435641073000},"page":"1771-1777","source":"Crossref","is-referenced-by-count":5,"title":["Aortic and Mitral Calcification Is Marker of Significant Carotid and Limb Atherosclerosis in Patients with First Acute Coronary Syndrome"],"prefix":"10.1111","volume":"32","author":[{"given":"Anna","family":"Sannino","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Advanced Biomedical Sciences Federico II University Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria\u2010Angela","family":"Losi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Advanced Biomedical Sciences 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