Relationship Between Carotid Artery Disease And Coronary Artery Disease

Objective:To explore the relationship between carotid artery disease by ultrasound and coronary disease by coronary computed tomography angiography, and to predict coronary artery disease by carotid ultrasound parameters.Methods:A total of 598 patients suspected coronary heart disease or unknown cause chest pain received carotid ultrasound and coronary computed tomography angiography. coronary artery disease was compared with carotid artery disease by categorical severity and number of coronary artery atherosclerosis and carotid IMT. And our study found independent predictors of coronary artery disease by stepwise Logistic regression.Results:A total of 598 patients underwent carotid ultrasound and CTA within a week. By the univariate analysis we found that sex(160:167 vs 83:188,P< 0.001),age (66.88±9.24 vs 60.23±8.12,P< 0.001),diabetes(81:246 vs 39:232,P=0.002),hypertension(221:106 vs 116:155,P< 0.001),smoking (102:225 vs 44:227,P< 0.001),carotid plaque(257:70 vs 154:117,P<0.001) and carotid IMT≥1mm (151:176 vs 53:218,P< 0.001) were higher in patients with coronary artery disease compared with patients without coronary artery disease, and HDL (1.21±0.28 vs 1.31±0.34,P<0.001) was lower in patients with coronary artery disease compared with patients without coronary artery disease. Carotid IMT in different kinds of severity of coronary artery narrow groups were significantly higher than those of no narrow group(P<0.05). The incidence rate of carotid plaque in none,0-25%,25%-50%,50%-75% and 75%-100% coronary artery narrow groups were 56.8%,64.3%,80.7%, 83.5% and 90.0%(P<0.001).Carotid IMT in triple and fourfold vessel coronary disease groups were significantly higher than those of none or single-double lesion groups(P<0.05).The incidence rate of carotid plaque in none, single-double, triple and fourfold vessel coronary disease groups were 56.8%,75.3%,89.6% and 81.0%(P< 0.001). Stepwise Logistic regression analysis showed that the adjusted odds ratio of carotid plaque and carotid IMT≥1mm caused coronary arteries disease was 1.615 and 1.829 respectively, and the adjusted odds ratio of male, elderly and hypertension for coronary arteries disease were 2.037,3.074 and 1.968 respectively, the adjusted odds ratio of combining carotid plaque with carotid IMT≥lmm caused coronary arteries disease was 2.258.Conclusions:Carotid plaque and increased carotid IMP are associated with the presence, severity and number of coronary artery disease. Carotid plaque and carotid IMT≥1mm may be predictors for coronary arteries disease independent of age, sex and hypertension. Combining carotid plaque with carotid IMT≥1mm is better than using either alone for predicting coronary arteries disease.