Yonsei Med J.  2019 Jun;60(6):542-546. 10.3349/ymj.2019.60.6.542.

Prevalence and Clinical Outcomes of Asymptomatic Carotid Artery Stenosis in Patients Undergoing Concurrent Coronary and Carotid Angiography

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. byungokim@paik.ac.kr

Abstract

PURPOSE
The prevalence and clinical outcomes of asymptomatic carotid artery stenosis (CAS) in patients with coronary artery disease (CAD) have not been thoroughly studied. We examined the prevalence and predictors of asymptomatic CAS detected by carotid angiography and determined the impact of concomitant CAS on prognosis in patients undergoing coronary angiography (CAG) due to CAD.
MATERIALS AND METHODS
Between January 2013 and July 2015, 395 patients who underwent carotid digital subtraction angiography to screen for CAS during CAG were analyzed. The presence of CAS was defined as angiographically significant stenosis (≥50%). Major adverse cardiac and cerebrovascular event (MACCE) rates were compared between patients with and without CAS. MACCEs included a composite of cardiac death, cerebrovascular death, acute myocardial infarction, and stroke.
RESULTS
Of the 395 patients, 101 (25.5%) patients had significant CAS. The independent predictors of CAS were age, male sex, hypertension, diabetes, and multi-vessel disease. In patients with CAD, the presence of CAS was as an independent predictor for MACCEs after adjusting for confounding factors (hazard ratio 2.47, 95% confidence interval 1.16-5.24, p=0.018).
CONCLUSION
Asymptomatic CAS was documented in up to 25% of patients with CAD. The presence of CAS in patients with CAD was associated with a higher rate of MACCEs. Therefore, detection of CAS by carotid angiography during CAG may be important for risk stratification for CAD patients, particularly those with multi-vessel disease.

Keyword

Carotid stenosis; coronary artery disease; coronary angiography; digital subtraction angiography

MeSH Terms

Angiography*
Angiography, Digital Subtraction
Carotid Arteries*
Carotid Stenosis*
Constriction, Pathologic
Coronary Angiography
Coronary Artery Disease
Death
Humans
Hypertension
Male
Myocardial Infarction
Prevalence*
Prognosis
Stroke
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