Usefulness of ultrasonographic markers of carotid atherosclerosis (intima–media thickness, unstable carotid plaques and severe carotid stenosis) for predicting presence and extent of coronary artery disease
- 1 December 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Cardiovascular Medicine
- Vol. 10 (12), 906-912
- https://doi.org/10.2459/jcm.0b013e32832e62fd
Abstract
Objective To investigate the usefulness of carotid ultrasound evaluation in predicting the presence and the extent of coronary artery disease in a consecutive series of patients. Design We examined retrospectively 1337 patients in whom both coronary angiography and carotid ultrasound were evaluated, from 1995 to 2005. Markers of carotid artery disease were considered, such as intima–media thickness more than 0.90 mm, unstable plaque and severe stenosis (≥70%). Carotid risk score was defined as the sum of these parameters. We considered as affected by significant coronary artery disease those patients with at least one lesion more than 50% within the main branches of the coronary arteries. Results The markers of carotid atherosclerosis increased proportionally in patients with one-, two- or three-vessel coronary artery disease. At univariate analysis, intima–media thickness more than 0.90 mm was associated with an odds ratio of coronary artery disease of 2.28 (1.8–2.9) (P < 0.0001), unstable plaque 3.6 (2.3–5.7) (P < 0.001) and severe carotid stenosis 4.2 (2.0–8.7) (P = 0.0001). At multivariate analysis, the three markers mentioned above were independent risk factors for coronary artery disease even when considering other risk factors. Conclusion We confirmed the usefulness of carotid ultrasound evaluation in predicting the presence and extent of coronary artery disease. Considering the high correlation between carotid and coronary artery disease, carotid screening is useful in patients with coronary artery disease. In patients with an occasional finding of a carotid risk score of at least 2, a careful search for coronary artery disease seems warranted.Keywords
This publication has 17 references indexed in Scilit:
- Carotid intima-media thickness and coronary atherosclerosis: weak or strong relations?European Heart Journal, 2007
- Prediction of Clinical Cardiovascular Events With Carotid Intima-Media ThicknessCirculation, 2007
- From Vulnerable Plaque to Vulnerable Patient—Part III: Executive Summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force ReportThe American Journal of Cardiology, 2006
- Association of Carotid Intima-Media Thickness With Angiographic Severity and Extent of Coronary Artery DiseaseThe American Journal of Cardiology, 2006
- Association of Subclinical Wall Changes of Carotid, Femoral, and Popliteal Arteries With Obstructive Coronary Artery Disease in Patients Undergoing Coronary AngiographyChest, 2005
- Association of increased carotid intima-media thickness with the extent of coronary artery diseaseHeart, 2004
- Surrogate Markers for Cardiovascular DiseaseCirculation, 2004
- Early results of percutaneous intervention for severe coexisting carotid and coronary artery diseaseThe American Journal of Cardiology, 1999
- Association of Coronary Heart Disease Incidence with Carotid Arterial Wall Thickness and Major Risk Factors: The Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993American Journal of Epidemiology, 1997
- Evaluation of the associations between carotid artery atherosclerosis and coronary artery stenosis. A case-control study.Circulation, 1990