Association between carotid and coronary artery disease in patients with aortic valve stenosis: an angiographic study
Francesco Antonini-Canterin1, Elisa Leiballi, Michele Capanna
1Cardiologia, ARC, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy. cardiologia@aopn.fvg.it
Insights
Patients with aortic stenosis and carotid artery disease have a high likelihood of also having coronary artery disease. Carotid artery disease is a strong predictor of coronary artery disease in these patients.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Aortic stenosis frequently coexists with coronary artery disease.
- Limited data exists on the association between coronary artery disease and carotid artery disease in patients with aortic stenosis.
Purpose of the Study:
- To investigate the relationship between carotid artery disease and coronary artery disease in patients undergoing aortic valve replacement.
Main Methods:
- 317 patients with aortic stenosis underwent simultaneous carotid and coronary angiography.
- Univariate and multivariate analyses were performed to identify predictors of coronary artery disease.
Main Results:
- Carotid artery disease, angina, and age were independent predictors of coronary artery disease.
- The combination of carotid artery disease and angina identified groups with varying coronary artery disease prevalence, from 21% to 85%.
Conclusions:
- Significant carotid artery disease is a robust marker for significant coronary artery disease in patients with symptomatic aortic stenosis.
- Identifying carotid artery disease can aid in risk stratification for coronary artery disease in this population.
Background:
Patients with aortic stenosis have a high prevalence of coronary artery disease, but there is little information about the association of coronary artery disease and carotid artery disease.
Methods:
The study includes 317 consecutive patients with aortic stenosis, who underwent carotid and coronary angiography during the same catheterization before aortic valve replacement.
Results:
At univariate analysis, the prevalence of coronary artery disease was associated with (1) presence of carotid artery disease (P < .001); (2) angina pectoris as presentation symptom (P < .001); (3) age more than 65 years (P < .05); and (4) hypertension (P < .05). At multivariate analysis, only carotid artery disease, angina, and age emerged as independent predictors of coronary artery disease. The combination of 2 variables (carotid artery disease, angina) allowed the identification of 4 groups, with decreasing prevalence of coronary artery disease: (1) angina+/carotid artery disease+: 85%; (2) angina-/ carotid artery disease+: 50%; (3) angina+/carotid artery disease-: 41%; (4) angina-/carotid artery disease-: 21% (P < .001).
Conclusion:
In patients with symptomatic aortic stenosis, the presence of significant carotid artery disease is a strong marker of significant coronary artery disease.
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