Key result
Coronary artery disease was an independent risk factor for internal carotid artery stenosis (OR 3.87, P=0.023), and CAD severity significantly correlated with ICAS severity.
Why the study?
Evidence defining the clinically relevant association between coronary artery disease and internal carotid artery stenosis remains inconclusive.
Does the presence and severity of CAD predict internal carotid artery stenosis in ambulatory patients presenting for non-emergent PCA?
Cross-Sectional (n=121)
No
Does the presence and severity of CAD predict internal carotid artery stenosis in ambulatory patients presenting for non-emergent PCA?
Effect estimate: OR 3.87
p-value: p=0.023
CAD is an independent predictor of ICAS in ambulatory patients undergoing non-emergent PCA, though most ICAS is minor.
May warrant selective carotid evaluation in CAD patients undergoing PCA; leaves open whether detection improves outcomes.
Introduction Association between coronary artery disease (CAD) and internal carotid artery stenosis (ICAS) could prove clinically relevant. However, evidence defining this association is currently inconclusive. Our study investigates the prevalence of ICAS in non‐emergent, ambulatory patients presenting for PCA with suspected CAD in an Australian context. Methods Between February 2019 and June 2019, 121 consecutive participants were verbally consented and enrolled in our study. The data were analysed retrospectively. PCA and CUS were performed within 24 h of each other. Multinomial logistic regression assessed independent predictors for ICAS, with statistical significance set at P value < 0.05. Linear regression analysis correlated CAD and ICAS severity, with significance of a P‐value < 0.05. Analysis was conducted using IBM SPSS 26 software (Chicago, Illinois). Results The final study included 121 patients (age 73 ± 9 years, 76.9% male). ICAS on CUS was present in 55.4% of participants for PCA. CAD was an independent risk factor for ICAS on multinomial logistic regression odds ratio 3.87 (P = 0.023). CAD severity (multi vessel disease) showed significant correlation with ICAS r = 0.22 (P = 0.014) using linear regression analysis. Conclusion CAD is an independent predictor of ICAS, and severity of ICAS is correlated with CAD disease. However, most participants had only minor ICAS (16–49% diameter stenosis). Our findings are consistent with internationally published studies, suggesting their data are generalisable to the Australian population. Larger studies are needed to address the applicability of CUS screening in patients with advanced CAD.
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O’Brien et al. (2020) conducted a cross-sectional in Suspected coronary artery disease (CAD) (n=121). Coronary artery disease (CAD) was evaluated on Internal carotid artery stenosis (ICAS) (OR 3.87, p=0.023). Coronary artery disease was an independent risk factor for internal carotid artery stenosis (OR 3.87, P=0.023), and CAD severity significantly correlated with ICAS severity.
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