Prevalence and Clinical Outcomes of Asymptomatic Carotid Artery Stenosis in Patients Undergoing Concurrent Coronary and Carotid Angiography
10.3349/ymj.2019.60.6.542
- Author:
Jongkwon SEO
1
;
Gwang Sil KIM
;
Hye Young LEE
;
Young Sup BYUN
;
In Hyun JUNG
;
Kun Joo RHEE
;
Byung Ok KIM
Author Information
1. Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. byungokim@paik.ac.kr
- Publication Type:Original Article
- Keywords:
Carotid stenosis;
coronary artery disease;
coronary angiography;
digital subtraction angiography
- MeSH:
Angiography;
Angiography, Digital Subtraction;
Carotid Arteries;
Carotid Stenosis;
Constriction, Pathologic;
Coronary Angiography;
Coronary Artery Disease;
Death;
Humans;
Hypertension;
Male;
Myocardial Infarction;
Prevalence;
Prognosis;
Stroke
- From:Yonsei Medical Journal
2019;60(6):542-546
- CountryRepublic of Korea
- Language:English
-
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.
