Vol 70, No 4 (2012)
Original articles
Published online: 2012-04-24

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Impact of atherosclerotic changes of carotid vessels on long−term outcome in relatively young patients with acute coronary syndrome

Agnieszka Drzewiecka−Gerber, Anna Rybicka−Musialik, Jarosław Myszor, Damian Ziaja, Maria Trusz−Gluza
DOI: 10.33963/v.kp.78952
Kardiol Pol 2012;70(4):343-349.

Abstract

Background: Complex stenoses of coronary vessels as well as unstable plaques are part of the widespread atherosclerotic process.
Aim:
The possible association between the incidence of unstable coronary artery disease (CAD) and the morphology of carotid artery wall and cardiovascular events (MACE) was assessed prospectively in a two-year follow-up study.
Methods and results:
Ninety-seven consecutive patients, aged under 60, admitted to hospital with suspected acute coronary syndrome (ACS) were included. Angiography was performed in all patients. Coronary artery disease was confirmed in 78 patients. This was the CAD(+) group. In 19 patients, coronary arteries were normal. This was the CAD(–) group. In all cases, carotid ultrasound was performed before discharge and at two-year follow-up, with evaluation of carotid arteries wall morphology: carotid intima-media thickness (CIMT) in far distal wall of common carotid artery and the presence of plaques. Carotid atherosclerosis was defined as CIMT > 0.9 mm or incidence of plaques; MACE was defined as death, ACS, stroke or need for urgent coronary revascularisation. Sixty patients from the CAD(+) group met the carotid atherosclerosis criteria. This was named the CAR(+) subgroup; 18 patients with normal carotid morphology comprised the CAR(–) subgroup. During the two years, MACE occurred only in the CAD(+) group (22 events). There was no statistical difference in the MACE-free survival curve of the CAR(+) and CAR(–) subgroups (p = 0.91).
Conclusions:
The presence of atherosclerotic process in carotid region coexists well with the incidence of CAD; however, it does not determine prognosis after ACS.

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Polish Heart Journal (Kardiologia Polska)