Prevalence and Clinical Outcomes of Asymptomatic Carotid Artery Stenosis in Patients Undergoing Concurrent Coronary and Carotid Angiography
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Purpose: The prevalence and clinical outcomes of asymptomatic carotid artery stenosis (CAS) in patients with coronary arterydisease (CAD) have not been thoroughly studied. We examined the prevalence and predictors of asymptomatic CAS detected bycarotid angiography and determined the impact of concomitant CAS on prognosis in patients undergoing coronary angiography(CAG) due to CAD. Materials and Methods: Between January 2013 and July 2015, 395 patients who underwent carotid digital subtraction angiographyto screen for CAS during CAG were analyzed. The presence of CAS was defined as angiographically significant stenosis(≥50%). Major adverse cardiac and cerebrovascular event (MACCE) rates were compared between patients with and withoutCAS. MACCEs included a composite of cardiac death, cerebrovascular death, acute myocardial infarction, and stroke. Results: Of the 395 patients, 101 (25.5%) patients had significant CAS. The independent predictors of CAS were age, male sex, hypertension,diabetes, and multi-vessel disease. In patients with CAD, the presence of CAS was as an independent predictor forMACCEs after adjusting for confounding factors (hazard ratio 2.47, 95% confidence interval 1.16–5.24, p=0.018). Conclusion: Asymptomatic CAS was documented in up to 25% of patients with CAD. The presence of CAS in patients with CADwas associated with a higher rate of MACCEs. Therefore, detection of CAS by carotid angiography during CAG may be importantfor risk stratification for CAD patients, particularly those with multi-vessel disease.
Abstract
Purpose: The prevalence and clinical outcomes of asymptomatic carotid artery stenosis (CAS) in patients with coronary arterydisease (CAD) have not been thoroughly studied. We examined the prevalence and predictors of asymptomatic CAS detected bycarotid angiography and determined the impact of concomitant CAS on prognosis in patients undergoing coronary angiography(CAG) due to CAD. Materials and Methods: Between January 2013 and July 2015, 395 patients who underwent carotid digital subtraction angiographyto screen for CAS during CAG were analyzed. The presence of CAS was defined as angiographically significant stenosis(≥50%). Major adverse cardiac and cerebrovascular event (MACCE) rates were compared between patients with and withoutCAS. MACCEs included a composite of cardiac death, cerebrovascular death, acute myocardial infarction, and stroke. Results: Of the 395 patients, 101 (25.5%) patients had significant CAS. The independent predictors of CAS were age, male sex, hypertension,diabetes, and multi-vessel disease. In patients with CAD, the presence of CAS was as an independent predictor forMACCEs after adjusting for confounding factors (hazard ratio 2.47, 95% confidence interval 1.16–5.24, p=0.018). Conclusion: Asymptomatic CAS was documented in up to 25% of patients with CAD. The presence of CAS in patients with CADwas associated with a higher rate of MACCEs. Therefore, detection of CAS by carotid angiography during CAG may be importantfor risk stratification for CAD patients, particularly those with multi-vessel disease.
참고문헌 (10)
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