Korean Circ J.  2016 Sep;46(5):639-645. 10.4070/kcj.2016.46.5.639.

Association between the Gensini Score and Carotid Artery Stenosis

• Avci A
• Fidan S
• Tabakçı
• Toprak C
• Alizade E
• Acar E
• Bayam E
• Tellice M
• Naser A
• Kargın R

• KMID: 2389620
• DOI: http://doi.org/10.4070/kcj.2016.46.5.639

Abstract

BACKGROUND AND OBJECTIVES
The aim of this study was to evaluate the association between the extent of coronary artery disease assessed by the Gensini score and/or the SYNTAX score and the significant carotid stenosis in patients undergoing coronary artery bypass grafting (CABG).
SUBJECTS AND METHODS
A total of 225 patients who had carotid doppler ultrasonography prior to CABG were included retrospectively. Significant coronary artery disease was assumed as a lumen diameter stenosis of ≥50% in any of the major epicardial coronary arteries. The severity of carotid stenosis was determined by B-mode and duplex ultrasonography. Clinically significant carotid stenosis was defined as peak systolic velocity greater than 125 cm/s.
RESULTS
The mean value of SYNTAX score and Gensini score was highest in patients allocated to significant carotid stenosis (22.98±7.32, p<0.001 and 77.40±32.35, p<0.001, respectively). The other risk factors for significant carotid stenosis were found to be male gender (p=0.029), carotid bruit (p<0.001), diabetes (p=0.021), left main disease (p=0.002), 3-vessel disease (p=0.008), chronic total coronary occlusion (p=0.001), and coronary artery calcification (p=0.001) in univariate analysis. However, only the Gensini score (odds ratio[OR]=1.030, p=0.004), carotid bruit (OR=0.068, p<0.001), and male gender (OR=0.190, p=0.003) were the independent predictors. The Gensini score cut off value predicting significant carotid stenosis was 50.5 with 77% sensitivity (p<0.001).
CONCLUSION
The Gensini score may be used to identify patients at high risk for significant carotid stenosis prior to CABG.

Keyword

Coronary atherosclerosis; Carotid artery disease; Doppler ultrasonography

MeSH Terms

Carotid Arteries*
Carotid Artery Diseases
Carotid Stenosis*
Constriction, Pathologic
Coronary Artery Bypass
Coronary Artery Disease
Coronary Occlusion
Coronary Vessels
Humans
Male
Retrospective Studies
Risk Factors
Ultrasonography
Ultrasonography, Doppler

Figure

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  Fig. 1 Comparison of the Gensini score and the SYNTAX score between the groups according to the severity of carotid artery stenosis.

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  Fig. 2 Distribution of the patients with various severity of CAS between the tertiles of Gensini score. CAS: carotid artery stenosis.

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  Fig. 3 Receiver operating characteristic curve of the Gensini score for predicting significant CAS in patients undergoing CABG. CAS: carotid artery stenosis, CABG: coronary artery bypass grafting, AUC: area under the curve.

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