scholarly journals Carotid Atherosclerosis in Predicting Coronary Artery Disease

Author(s):  
Ibadete Bytyçi ◽  
Rafik Shenouda ◽  
Per Wester ◽  
Michael Y. Henein

Objective: This meta-analysis aims to compare the relationship between phenotypic manifestation of coronary and carotid atherosclerosis using available imaging techniques. Approach and Results: We searched all electronic databases until October 2020 for studies which reported relationship between carotid and coronary atherosclerosis. The primary end point was correlation between carotid intima-media thickness (CIMT) and carotid plaque features (calcification and lipid-rich necrotic core) with coronary artery disease (CAD). Secondary end points included carotid pathology that predicts CAD. Eighty-nine papers with 22 683 patients comparing carotid and coronary atherosclerosis were included in the analysis. CIMT was increased linearly with severity of CAD irrespective of its significance ( P <0.001), mono versus 2 vessel disease ( P =0.003), and 2 versus multivessel disease ( P <0.001). Carotid plaque presence and calcification were less, and lipid-rich necrotic core was highly prevalent in nonsignificant versus significant CAD ( P <0.001, P =0.03, P <0.001, respectively). Moderate correlation was found between CIMT and severity of CAD ( r =0.60, P <0.001) and the number of diseased vessels ( r =0.49, P <0.001). There was a moderate correlation between carotid and coronary stenosis ( r =0.53, P <0.001) and between carotid and coronary calcification ( r =0.61, P <0.001). CIMT ≥1.0 mm with a summary sensitivity of 77% and summary specificity of 72% and respective values of 80% and 67% for carotid plaque were the best predictors of CAD, irrespective of the technique used for its diagnosis. Conclusions: These results support the concept that atherosclerosis affects both carotid and coronary systems, although not always in identical phenotypic manner. These findings highlight the beneficial examination of carotid arteries whenever CAD is suspected.

ESC CardioMed ◽  
2018 ◽  
pp. 1331-1339
Author(s):  
Jeroen J. Bax

The inclusion or exclusion of coronary artery disease is important for patient management, both from a diagnostic and prognostic view, as well as from a therapeutic view. Various detection techniques are available, including invasive (coronary angiography) or non-invasive imaging techniques. The techniques can also be divided into anatomical imaging or functional imaging, where anatomical imaging detects coronary atherosclerosis and stenosis (invasive coronary angiography, but also non-invasive coronary angiography—performed with multidetector computed tomography), while functional imaging (nuclear imaging, stress echocardiography, and cardiovascular magnetic resonance) detects ischaemia: the haemodynamic consequences of the atherosclerosis/stenosis. The early phase of atherosclerotic coronary artery disease is often asymptomatic (and anatomical imaging can be used to detect/exclude coronary atherosclerosis), whereas with progression of atherosclerotic disease, symptoms occur related to myocardial ischaemia. Non-invasive imaging can facilitate in the detection of both early (asymptomatic) and more advanced (symptomatic, ischaemic) coronary artery disease. The pathophysiological cascade of cardiac abnormalities that occur once ischaemia is induced is referred to as the ischaemic cascade. The ischaemic cascade consists of chronological development of perfusion abnormalities, followed by diastolic dysfunction, then systolic dysfunction, and finally electrocardiographic abnormalities. In this chapter, the variety of the different non-invasive imaging techniques to assess the different phases of the non-ischaemic part and the ischaemic part (ischaemic cascade) of coronary artery disease are described.


2017 ◽  
Vol 95 (8) ◽  
pp. 878-887 ◽  
Author(s):  
Stéphanie LeBlanc ◽  
Karine Bibeau ◽  
Olivier F. Bertrand ◽  
Valérie Lévesque ◽  
Béatrice Deschênes St-Pierre ◽  
...  

Prediction of coronary events remains elusive. Carotid atherosclerosis may be a surrogate for coronary risk, as carotid and coronary diseases occur simultaneously — albeit at times with a weak association — depending on clinical presentation. We investigated carotid and coronary atherosclerosis in men with new-onset unstable coronary artery disease (CAD) presenting with acute ST-segment elevation myocardial infarction (STEMI) vs. long-standing severe chronic stable angina (CSA). Bilateral carotid artery and 3-vessel coronary artery atherosclerosis burdens were measured within 1 month, respectively, by 3D-volumetric carotid magnetic resonance imaging and coronary angiography-derived modified CASS-50 score. Men with STEMI (n = 50) and long-standing CSA (n = 50), matched for age, were enrolled (58.6 ± 8.8 years). All of them had carotid atherosclerosis. Atherosclerosis burden was greater in the carotid arteries of STEMI vs. CSA (wall volume: 196.2 ± 44.4 vs. 169.2 ± 38.0 mm3/4 mm, p = 0.002), but greater in the coronary arteries of CSA vs. STEMI (modified CASS-50 score: 3 vs. 1, p < 0.0001). Normalized wall index (NWI) of internal carotid was associated with modified CASS-50 score in STEMI (ρ = 0.40, p = 0.022) and in CSA (ρ = −0.39, p = 0.031). Carotid atherosclerosis was observed in all CAD patients, and atherosclerosis burden in carotid and in coronary arteries varied according to clinical presentation.


Author(s):  
Han-Young Jin ◽  
Jonathan R. Weir-McCall ◽  
Jonathon A. Leipsic ◽  
Jang-Won Son ◽  
Stephanie L. Sellers ◽  
...  

2017 ◽  
Vol 256 ◽  
pp. 29-34 ◽  
Author(s):  
Shinichi Nonin ◽  
Shinichi Iwata ◽  
Kenichi Sugioka ◽  
Suwako Fujita ◽  
Naoki Norioka ◽  
...  

Author(s):  
Thanh Huong Truong

TÓM TẮT Đặt vấn đề: Dữ liệu xơ vữa động mạch (ĐM) cảnh ở người mắc bệnh động mạch vành sớm (BĐMVS) còn hạn chế tại Việt Nam. Do đó, nghiên cứu này nhằm mục tiêu xác định tỉ lệ xơ vữa ĐM cảnh và các yếu tố liên quan đến tình trạng này ở người mắc BĐMVS tại Việt Nam. Đối tượng, phương pháp nghiên cứu: Đây là nghiên cứu mô tả với 94 người mắc BĐMVS được siêu âm ĐM cảnh. Kết quả: Tình trạng hẹp ĐM cảnh không ý nghĩa và có ý nghĩa quan sát thấy ở 16 (17.0%) và 4 bệnh nhân (4.3%), tương ứng. Phân tích hồi quy logistic đa biến thấy nồng độ lipoprotein cholesterol tỷ trọng thấp (LDL-C) trong máu liên quan độc lập với hẹp ĐM cảnh có ý nghĩa (Odds Ratio = 1.504). Kết luận: Tại Việt Nam, người mắc BĐMVS có tỉ lệ cao bị hẹp ĐM cảnh. Sàng lọc hẹp ĐM cảnh nên được thực hiện cho nhóm bệnh nhân này, đặc biệt là khi có kèm tăng LDL-máu. Từ khoá: Xơ vữa, hẹp động mạch cảnh, bệnh động mạch vành, sớm ABSTRACT BURDEN OF CAROTID ATHEROSCLEROSIS IN PATIENTS WITH PREMATURE CORONARY ARTERY DISEASE Background: Data about carotid atherosclerosis in patients with premature coronary artery disease (PCAD) is still limited in Vietnam. Therefore, this study aims to investigate the prevalence of carotid atherosclerosis in patients with PCAD and factors related to carotid stenosis in these patients in Vietnam. Methods: This is a cross-sectional study that enrolled 94 patients with PCAD. All of patients were screened carotid atherosclerosis using ultrasonography. Results: Non-significant andsignificant carotid stenosiswere observed in 16 patients (17.0%) and 4 patients (4.3%), respectively. Multivariate logistic regression analysis showed that serum low density lipoprotein cholesterol (LDL-C) level was independently related to the presence of carotid stenosis with Odds ratio as 1.504. Conclusions: Prevalence of carotid stenosis is high in patients with PCAD in Vietnam. Screening of carotid stenosis should be recommended in these patients, especially in whom with elevated LDL-C. Key words: Atherosclerosis, carotid stenosis,coronary artery disease, premature.


2014 ◽  
Vol 55 (3) ◽  
pp. 197-203 ◽  
Author(s):  
Se-Hong Kim ◽  
Ju-Hye Chung ◽  
Beom-June Kwon ◽  
Sang-Wook Song ◽  
Whan-Seok Choi

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