Key result
Mean carotid IMT exceeding 1.2 mm predicts concomitant CAD in patients with AS.
Why the study?
Aortic stenosis coexists with coronary artery disease in at least 30% of patients, and identifying concomitant CAD is important for management decisions such as simultaneous coronary bypass grafting.
Does carotid intima-media thickness predict concomitant coronary artery disease in patients with aortic stenosis?
Observational (n=103)
Does carotid intima-media thickness predict concomitant coronary artery disease in patients with aortic stenosis?
A mean carotid intima-media thickness greater than 1.2 mm is a useful non-invasive marker for predicting concomitant coronary artery disease in patients with aortic stenosis.
May aid noninvasive CAD risk stratification in aortic stenosis; leaves open need for prospective validation before practice change.
OBJECTIVE: Aortic stenosis (AS) coexists with coronary artery disease (CAD) in at least 30% of patients. Patients with concomitant CAD may benefit from simultaneous coronary bypass grafting. This study aimed to evaluate the prognostic value of carotid intima-media thickness (IMT) in patients with AS in assessing concomitant CAD. METHODS: Group I consisted of 33 patients (mean age +/- SD, 61.0 +/- 8.2 years; 18 men and 15 women) with AS but without CAD on angiograms. Group II consisted of 34 patients (64.4 +/- 8.0 years; 25 men and 9 women) with AS and CAD confirmed angiographically. A control group included 36 patients (61.2 +/- 4.9 years; 18 men and 18 women) with normal coronary arteries and no AS. Maximal IMT was assessed in all patients at the common carotid artery, bulb, and internal carotid artery and expressed as a mean value. RESULTS: There were no differences among the respective groups with regard to age, sex, frequency of hypertension, diabetes, and smoking habit, although patients with CAD were more often hyperlipemic (P = .038). The IMT of the common carotid artery, bulb, and internal carotid artery was significantly higher in patients with AS and CAD compared with both the control group and patients with AS only. The multivariable regression model revealed that CAD (P < .001), AS (P = .006), male sex (P = .034), age (P < .001), and diabetes mellitus (P = .047) were independent risk factors for IMT thickening. A mean IMT value of greater than 1.2 mm was predictive (sensitivity, 73.5%; specificity, 72.7%) of concomitant CAD in patients with AS. CONCLUSIONS: Intima-media thickness increases in patients with AS. The greatest IMT values are observed in patients with both AS and CAD. Patients with AS might be suspected of having CAD when the IMT value exceeds 1.2 mm.
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Kabłak-Ziembicka et al. (2005) conducted an observational in Aortic stenosis and coronary artery disease (n=103). Carotid intima-media thickness vs. Patients with aortic stenosis only or healthy controls was evaluated on Concomitant coronary artery disease in patients with aortic stenosis. A mean carotid intima-media thickness greater than 1.2 mm predicted concomitant coronary artery disease in patients with aortic stenosis with 73.5% sensitivity and 72.7% specificity.
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