Carotid Angiographic Profile in Patients with Coronary Artery Disease

Abstract

Background: This study was conducted with an aim of assessing the angiographic incidence of carotid artery stenosis (CAS) in patients undergoing coronary angiography for the diagnosis of coronary artery disease (CAD). Methods: This single centre study included 50 patients with stable CAD or acute coronary syndromes, undergoing coronary angiography for diagnostic or therapeutic indications, who gave consent for concomitant carotid digital subtraction angiography (DSA). Significant CAD was defined as ≥ 50% diameter stenosis in at least one major coronary artery or its first order branches, and was categorized as single vessel disease (SVD), double vessel disease (DVD), or triple vessel disease (TVD) according to number of vessels involved. Significant CAS was defined as a diameter stenosis of ≥50% in the common carotid artery, the carotid bifurcation, or the internal carotid artery. For statistical analysis, patients were divided into two groups i.e. patients without or with CAS. Patient characteristics in these groups were then analysed and compared to each other. Results: The mean age of study group was 58.72 ± 9.03 years. Out of 50 patients studied 33 (66%) were males and 17 (34%) were females. Risk factors included hypertension, smoking, diabetes mellitus and dyslipidemia in 82%, 50%, 48% and 28% patients respectively. CAD was present in 62% patients; with 24%, 14% and 24% patients having SVD, DVD and TVD respectively. CAS was present in 10 (20%) patients, all of whom had TVD on coronary angiography (p≤0.0001). Patients with CAS were more likely to be older than those without CAS (p=0.065). Additionally, 80% of patients with CAS were males and all of them were hypertensive. Conclusion: Significant CAS is found in substantial proportion of patients with CAD, especially multi vessel disease. A strategy of concomitant carotid DSA at the time of coronary angiography may allow superior risk stratification and better planning of management in these patients. Key words: Carotid artery stenosis, Carotid angiography, Coronary Artery Disease.