Chronic venous insufficiency as an independent risk factor for coronary artery disease: Evidence from coronary artery calcium score analysis

Abstract

Background

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.

Methods

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 p < .05.

Results

Comparison between CVI group (n = 234) and cardiac ablation group (n = 234) were as follows: mean age (71 ± 9:71 ± 9, not significant (NS)), females (154:145, NS), body mass index (BMI) (23.6 ± 3.9:22.6 ± 3.5, p = .004), hypertension (103:121, NS), dyslipidemia (100:66, p = .001), diabetes (30:24, NS), Creatinine (0.76 ± 0.25:0.87 ± 0.64, p = .02), respectively. The total CACS was 214 ± 578 in the CVI group and 64.8 ± 233 in the cardiac ablation group (p < .001). The median CACS values were 14.8 (IQR: 0–178) and 0 (IQR: 0–16), respectively. CVI group included 35% with CACS >100 and the cardiac ablation group did 12%, respectively (p < .001). Univariate analysis identified age [beta 9.6 (95% CI 5.2 to 13.9), p < .001], hypertension [beta 142.4 (95% CI 62.5 to 222), diabetes [beta 179.1 (95% CI 53.5 to 305), p = .005], dyslipidemia [beta 164.5 (95% CI 81.2 to 248), p < .001],creatinine [beta 85.4 (95% CI 2.6 to 168), p = .04], and CVI [beta 149 (95% CI 69.4 to 229), p < .001], p = .001] as risk factors. Multivariate analysis revealed age [beta 7.1 (95% CI 2.7 to 11.5), p = .002], hypertension [beta 86.5 (95% CI 1.7 to 171), p = .046], dyslipidemia [beta87.5 (95% CI 1.4 to 174), p = .047], and CVI [beta 143.6 (95% CI 63.7 to 223), p < .001] as strong correlates of CACS.

Conclusions

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.