Carotid artery stenosis and ultrasound vascular indexes predict the coronary revascularization in patients with high cardiovascular risk scheduled for coronary angiography

Abstract

Background: Carotid artery atherosclerosis is a complex and multifactorial chronic disease.

Aims: We aimed to assess the predictive value of cardiovascular (CV) risk factors, carotid artery stenosis (CAS), and ultrasound vascular indices for coronary revascularization in patients referred for coronary angiography.

Methods: Patients scheduled for elective coronary angiography were enrolled. The following ultrasound indices were obtained: CAS, carotid intima‑media thickness (IMT), extra‑media thickness (EMT), intra‑abdominal thickness (IAT), and the combined PATIMA index.

Results: The study included 322 patients (118 women, 204 men) with CV risk factors (mean [SD] number, 5.4 [1.5]) and coronary artery disease (n = 228; 71%) with equal rates of 1-, 2-, and 3-vessel disease (35%, 33%, and 32%, respectively). Indications for percutaneous or surgical coronary revascularization were reported for 158 patients (49%). Patients with and without revascularization had a similar total number of CV risk factors (mean [SD], 5.4 [1.3] vs 5.3 [1.1]; P = 0.9) and IAT (mean [SD], 74 [24] mm vs 77 [28] mm; P = 0.4). The receiver operating characteristic (ROC) curve analysis showed that baseline CAS, carotid IMT, EMT adjusted for body mass index, and PATIMA index have a similar significant predictive value for coronary revascularization (mean [SD] area under the ROC curve, 610 [31] u, 590 [31] u, 610 [32] u, and 630 [30] u, respectively).

Conclusions: The severity of CAS and carotid vascular indices (IMT, EMT, and PATIMA index) may predict coronary revascularization in patients with high or very high CV risk. Clinical assessment and the presence of CV risk factors do not add predictive value in these patients.