Prevalence of carotid and renal artery stenosis in patients with significant coronary artery disease

ABSTRACT

Atherosclerosis as a vascular disease can involve any artery in the body including large and medium sized arteries. Only a few angiographic studies have correlated the presence and severity of coronary artery disease with atherosclerosis in other arteries. The aim of this study is to evaluate the prevalence of the carotid and renal artery stenosis in patients with documented coronary artery disease and the role of predisposing risk factors for such affection in Egyptian patients. This study included 100 patients with documented significant coronary artery disease. All were subjected to carotid and renal angiography. They were divided into group I which included patients with significant carotid artery stenosis [>50%] either unilateral or bilateral, and group II which included patients with normal carotid. They divided again into group A which included patients with significant renal artery stenosis [>50%], while group B included patients with normal renal angiography. For all patients, random blood sugar, serum urea, creatinine and complete lipid profile was assessed. Group I included 17 patients while Group II included 83 patients with documented significant coronary artery disease. There were significant correlations between either of age, hypertension, dyslipedemia, diabetes mellitus and presence of carotid artery stenosis. While there was no relation between carotid artery stenosis with neither gender nor smoking. Number of the affected coronary arteries was the significant multivariate predictor of significant carotid artery stenosis. While group A included 7 patients and group B included 93 patients with documented coronary artery disease. Hypertension and serum levels of both urea and creatinine were significantly univariate predictor of the presence of renal artery stenosis. The significant multivariate predictor of presence of renal artery stenosis was serum level of blood urea. The prevalence of significant carotid artery stenosis with significant coronary artery disease was found to be 17%. The prevalence of significant renal artery stenosis with significant coronary artery disease was found to be 7%. Carotid artery disease is more common in patients with old age, hypertension, dyslipidemia and with more than two vessel diseased coronaries. Renal artery disease is more common in hypertensive patients with elevated blood urea and serum creatinine levels and with more than two vessel diseased coronaries