[Incidence of carotid atherosclerosis in patients undergoing a coronarographic study. A prospective study of 193...

Many studies have identified the interrelationship between carotid artery disease (CD) and coronary artery disease (CAD). The purpose of this study was to evaluate the real incidence of CD, using an echo-duplex technique, in patients hospitalized for diagnostic coronary angiography.

An ultrasound evaluation with echo-duplex of the carotid arteries was performed on 193 consecutive patients (152 males and 41 females) hospitalized for diagnostic coronary arteriography. Patients were divided into three groups: normal coronary angiography, coronary artery with stenosis < 70% (< 50% of left main), coronary artery with stenosis > or = 70% of a vessel (> or = 50% of left main). Carotid arteries were divided into normal arteries, arteries with stenosis < 50%, arteries with stenosis > or = 50% and < 70% and arteries with stenosis > or = 70%. Seventy-one patients had one-vessel disease, 42 had two-vessel disease and 49 had three-vessel disease (10 with left main disease). Out of 193 patients, 86 had CD and of these, 64 had a lumen stenosis < 50% and 22 a lumen stenosis > or = 50%. There was a strong correlation between the degree of carotid lumen stenosis and the extent of CAD. Carotid artery stenosis > or = 50% was present in 12.96% of the patients (21/162) with coronary stenosis > or = 70% of a vessel. In particular, 8.45% (6/71) and 9.52 (4/42) of patients with stenosis of 1 or 2 coronary vessels; 22.45% (11/49) with stenosis of 3 coronary vessels [40% (4/10) when the left main artery was involved].

Our study confirms the relatively high frequency of CD in patients with CAD and the correlation between the degree of carotid artery stenosis and the extent of CAD. This seems to justify the use of carotid echo-duplex investigation in patients hospitalized for diagnostic coronary angiography and indeed, it is mandatory before coronary revascularization (especially in aorta-coronary bypass).