Active Detection of the Extension of Atherothrombosis in High Risk Coronary Patients

Coronary artery disease is the first cause of death related to atherothrombosis. There is a close correlation between the extension of coronary artery disease and the severity of atherosclerotic lesions in extra coronary arterial beds. In addition, these symptomatic extracoronary lesions dramatically decrease the survival of these patients. However, scant data are available regarding the prevalence of extracoronary asymptomatic lesions. Conversely, the annual absolute risk of these lesions remains unknown. Consequently, whether a systematic identification of these extracoronary asymptomatic lesions is relevant remains to be established. The Primary Objective and Primary Endpoint of the AMERICA study is to demonstrate the superiority of an active detection and management of the extension of atherothrombosis in high Risk coronary patients (active strategy) in comparison with standard of care for coronary atherosclerosis (conservative strategy).

Inclusion criteria

• Three vessel disease recently identified recently (<6 month)
• Accrue coronary syndromes in patients>75 years old (<1 month)

Exclusion criteria

• Absence of significant coronary lesions
• Other causes of rise in the troponin level
• Patient<18 years old
• Pregnant women
• Patient without affiliation to National Social Security