Prevalence and predictors of concomitant carotid and coronary artery atherosclerotic disease
Arie Steinvil1, Ben Sadeh, Yaron Arbel
1Department of Internal Medicine D at Tel-Aviv Sourasky Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. arikst@tasmc.health.gov.il
Insights
The severity of carotid artery stenosis (CAS) correlates with the extent of coronary artery disease (CAD). However, clinically significant CAS prevalence is lower in certain CAD groups than previously thought.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Diagnostic Imaging
Background:
- Prevalence of combined coronary and carotid atherosclerosis varies due to differing study designs.
- Understanding this relationship is crucial for comprehensive patient risk assessment.
Purpose of the Study:
- To evaluate the association between coronary artery disease (CAD) and carotid artery stenosis (CAS).
- To apply current guidelines for defining CAS.
- To identify predictors of severe CAS.
Main Methods:
- Retrospective analysis of prospectively collected data from 1,405 patients undergoing simultaneous coronary angiography and carotid Doppler.
- Spearman correlations and logistic regression used to analyze data.
- Carotid artery stenosis defined by peak systolic velocity (PSV).
Main Results:
- 12.8% had significant CAS (PSV >125 cm/s) and 4.6% had severe CAS (PSV >230 cm/s).
- Mild CAS was present in 58% of patients.
- A significant correlation (r=0.255, p<0.001) was found between CAS severity and extent of CAD.
- Independent predictors of severe CAS included left-main or 3-vessel CAD, age, stroke history, smoking, and diabetes.
Conclusions:
- The degree of internal carotid artery (ICA) stenosis is linked to the extent of CAD.
- The prevalence of clinically significant ICA stenosis appears lower in specific CAD subsets than previously reported.
Objectives:
The purpose of this research was to evaluate the relationship between coronary and carotid atherosclerotic disease using current guidelines for the definition of carotid artery stenosis (CAS).
Background:
The reported prevalence of concomitant coronary and carotid atherosclerotic disease has varied among studies due to differences in study populations and methodologies used.
Methods:
We performed a retrospective analysis of prospectively collected data obtained between January 2007 and May 2009 from consecutive patients undergoing same-day coronary angiography and carotid Doppler studies. Spearman correlations and multinomial logistic regression models were used to identify independent correlates of CAS.
Results:
The study included 1,405 patients (age 65 ± 11 years, 77.2% male), of whom 12.8% had significant CAS (peak systolic velocity [PSV] >125 cm/s) and 4.6% had severe CAS (PSV >230 cm/s). Mild CAS (PSV <125 cm/s and the presence of a sonographic atherosclerotic lesion) was present in 58%. The severity of CAS and the extent of coronary artery disease (CAD) were significantly correlated (r = 0.255, p < 0.001). Independent predictors of severe CAS defined by PSV were the presence of left-main or 3-vessel CAD, increasing age, a history of stroke, smoking status, and diabetes mellitus.
Conclusions:
The degree of internal carotid artery (ICA) stenosis is related to the extent of CAD, though the prevalence of clinically significant ICA stenosis is lower in specific CAD subsets than previously reported.
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