{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:45:49Z","timestamp":1777916749628,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Phlebology"],"published-print":{"date-parts":[[2025,12]]},"abstract":"\n Background<\/jats:title>\n Previous research has indicated a correlation between chronic venous insufficiency (CVI) and cardiovascular disease. However, whether CVI is an independent risk factor for coronary artery disease (CAD) remains underexplored. This study aimed to investigate this relationship by utilizing coronary artery calcium score (CACS) assessment during CVI screening and comparing it with CACS in patients undergoing cardiac ablation treatment.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n and Subjects: A retrospective cohort study was conducted, approved by the ethical committee (IRB 2024012). From February to July 2023 Simultaneous non-contrast lower limb vein CT and CACS measurements were performed on CVI patients aged 50 and above and less than 90, excluding cases with history of heart failure, post-thrombotic syndrome, percutaneous coronary intervention (PCI), cardiac ablation, cardiac surgery, peripheral arterial disease, and renal failure. Parameters included coronary risk factors and CACS. Control group was composed of sex- and age-matched patients receiving cardiac ablation treatment from April 2020 to December 2023. A comparison between the two groups was made, and univariate and multivariate analyses were conducted. Statistical significance was set at\n p<\/jats:italic>\n < .05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Comparison between CVI group (\n n<\/jats:italic>\n = 234) and cardiac ablation group (\n n<\/jats:italic>\n = 234) were as follows: mean age (71 \u00b1 9:71 \u00b1 9, not significant (NS)), females (154:145, NS), body mass index (BMI) (23.6 \u00b1 3.9:22.6 \u00b1 3.5,\n p<\/jats:italic>\n = .004), hypertension (103:121, NS), dyslipidemia (100:66,\n p<\/jats:italic>\n = .001), diabetes (30:24, NS), Creatinine (0.76 \u00b1 0.25:0.87 \u00b1 0.64,\n p<\/jats:italic>\n = .02), respectively. The total CACS was 214 \u00b1 578 in the CVI group and 64.8 \u00b1 233 in the cardiac ablation group (\n p<\/jats:italic>\n < .001). The median CACS values were 14.8 (IQR: 0\u2013178) and 0 (IQR: 0\u201316), respectively. CVI group included 35% with CACS >100 and the cardiac ablation group did 12%, respectively (\n p<\/jats:italic>\n < .001). Univariate analysis identified age [beta 9.6 (95% CI 5.2 to 13.9),\n p<\/jats:italic>\n < .001], hypertension [beta 142.4 (95% CI 62.5 to 222), diabetes [beta 179.1 (95% CI 53.5 to 305),\n p<\/jats:italic>\n = .005], dyslipidemia [beta 164.5 (95% CI 81.2 to 248),\n p<\/jats:italic>\n < .001],creatinine [beta 85.4 (95% CI 2.6 to 168),\n p<\/jats:italic>\n = .04], and CVI [beta 149 (95% CI 69.4 to 229),\n p<\/jats:italic>\n < .001],\n p<\/jats:italic>\n = .001] as risk factors. Multivariate analysis revealed age [beta 7.1 (95% CI 2.7 to 11.5),\n p<\/jats:italic>\n = .002], hypertension [beta 86.5 (95% CI 1.7 to 171),\n p<\/jats:italic>\n = .046], dyslipidemia [beta87.5 (95% CI 1.4 to 174),\n p<\/jats:italic>\n = .047], and CVI [beta 143.6 (95% CI 63.7 to 223),\n p<\/jats:italic>\n < .001] as strong correlates of CACS.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Multivariate analysis indicated that CVI is an independent risk factor for coronary artery disease, even after adjusting for age, hypertension, and dyslipidemia as confounding factors.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/02683555251336447","type":"journal-article","created":{"date-parts":[[2025,4,19]],"date-time":"2025-04-19T07:28:34Z","timestamp":1745047714000},"page":"754-763","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic venous insufficiency as an independent risk factor for coronary artery disease: Evidence from coronary artery calcium score analysis"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9350-7966","authenticated-orcid":false,"given":"Shinji","family":"Tomita","sequence":"first","affiliation":[{"name":"Gifu Heart Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Mizukami","sequence":"additional","affiliation":[{"name":"Showa University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Imai","sequence":"additional","affiliation":[{"name":"Gifu Heart Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taiji","family":"Miyake","sequence":"additional","affiliation":[{"name":"Gifu Heart Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Gifu Heart Center"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2023.06.005"},{"issue":"3","key":"e_1_3_7_3_2","first-page":"212","article-title":"Pathophysiology of chronic venous disease","volume":"33","author":"Raffetto JD","year":"2014","unstructured":"Raffetto JD, Mannello F. Pathophysiology of chronic venous disease. Int Angiol 2014; 33(3): 212\u2013221.","journal-title":"Int Angiol"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(18)31203-0"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab495"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab589"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-034245"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.3400\/avd.oa.15-00132"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.7134\/phlebol.15-1-19"},{"key":"e_1_3_7_10_2","first-page":"313","article-title":"Three-dimensional contrast-less computed tomography for varicose vein examination","volume":"56","author":"Miyazaki Y","year":"2013","unstructured":"Miyazaki Y, Nishimoto S, Ishii H, et al. Three-dimensional contrast-less computed tomography for varicose vein examination. Jpn J Plast Surg 2013; 56: 313\u2013316.","journal-title":"Jpn J Plast Surg"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90282-T"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.4065\/74.3.243"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.05.027"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpc.2022.100335"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-21-1041"},{"key":"e_1_3_7_16_2","unstructured":"Guidelines for diagnosis and treatment of acute and chronic heart failure (JCS 2017\/JHFS). 2017. https:\/\/www.j-circ.or.jp\/cms\/wp-content\/uploads\/2017\/06\/JCS2017_tsutsui_h.pdfv"},{"key":"e_1_3_7_17_2","unstructured":"Evidence-based clinical practice guideline for CKD. 2023. https:\/\/jsn.or.jp\/medic\/guideline\/pdf\/guide\/viewer.html?file=001-294.pdf"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2021.11.020"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.113.000690"},{"issue":"24","key":"e_1_3_7_20_2","first-page":"00221","article-title":"Current status and future perspective of coronary artery calcium score in asymptomatic individuals","volume":"0914","author":"Kawaguchi YO","year":"2024","unstructured":"Kawaguchi YO, Fujimoto S, Nozaki YO, et al. Current status and future perspective of coronary artery calcium score in asymptomatic individuals. J Cardiol 2024; S0914-5087(24): 00221.","journal-title":"J Cardiol"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.01.019"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355516686451"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2020.04.006"},{"issue":"4","key":"e_1_3_7_24_2","first-page":"335","article-title":"Association between symptoms of chronic venous disease in the lower extremities and cardiovascular risk factors in middle-aged women","volume":"30","author":"Auzky O","year":"2011","unstructured":"Auzky O, Lanska V, Pitha J, et al. Association between symptoms of chronic venous disease in the lower extremities and cardiovascular risk factors in middle-aged women. Int Angiol 2011; 30(4): 335\u2013341.","journal-title":"Int Angiol"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355515591394"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2023.03.013"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/02683555221108879"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/02683555241251647"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.4103\/VIT.VIT_28_24"}],"container-title":["Phlebology: The Journal of Venous Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02683555251336447","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02683555251336447","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02683555251336447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:55:41Z","timestamp":1777658141000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02683555251336447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,18]]},"references-count":28,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/02683555251336447"],"URL":"https:\/\/doi.org\/10.1177\/02683555251336447","relation":{},"ISSN":["0268-3555","1758-1125"],"issn-type":[{"value":"0268-3555","type":"print"},{"value":"1758-1125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,18]]}}}