Relationship Between Carotid and Coronary Atherosclerosis in the Elderly

ABSTRACT

BACKGROUND: The extent of carotid artery atherosclerosis as measured by B-mode ultrasound has been shown to be correlated with the presence or absence of coronary atherosclerotic disease(CAD), but no studies to date have used carotid B-mode ultrasound to compare the extent of atherosclerotic disease in the two arterial circulation. The aim of the present study was to examine the association between carotid artery and coronary artery atherosclerosis. METHODS: Four hundred fifty four consecutive elderly patients(220 men, 234 women) greater than 60 years of age who underwent coronary angiography for suspected CAD were evaluated by B-mode ultra- sound imaging of the both common carotid, proximal internal carotid and carotid bifurcation for measure- ment of atherosclerostic plaque. The severity of coronary atherosclerosis was judged by a consensus inter- pretation of coronary angiogram. CAD was defined as 50% or greater diameter stenosis of coronary artery. RESULTS: The presence of CAD was less than 10% in the elderly patients with less than 15% diameter stenosis of carotid artery, and was in the all elderly patient with 35% or greater diameter stenosis of carotid artery atherosclrosis. The predictability of 15% or greater carotid stenosis for CAD were 97.9% sensitivity, 54.6% specificity, 85.7% positive predictive value and 91.7% negative predictive valve and of 20% or greater were 92.1%, 70.4%, 89.9% and 78.6%, respectively. CONCLUSION: Carotid B-mode ultrasound is non-invasive, safe, and useful, and measurement of carotid artery plaque burden by B-mode ultrasonography expects to be rapidly being adopted as a reliable surro- gate for coronary artery atherosclerosis.