Key result
Adding carotid plaque assessment to exercise echocardiography fails to improve coronary artery disease prediction.
Why the study?
The study aimed to examine whether carotid condition is linked to coronary artery disease and if carotid ultrasonography improves exercise echocardiography's ability to predict CAD.
Does the addition of carotid ultrasonography to exercise echocardiography improve the prediction of coronary artery disease in participants without past heart disease?
Cross-Sectional (n=312)
Single-blind
No
Does the addition of carotid ultrasonography to exercise echocardiography improve the prediction of coronary artery disease in participants without past heart disease?
While carotid plaque presence is associated with coronary artery disease, adding carotid ultrasonography to exercise echocardiography does not significantly improve CAD prediction, though it may help reclassify patients for primary prevention.
Carotid plaque was associated with CAD yet added no predictive value to exercise echocardiography; leaves open incremental utility in adequately powered studies.
Objective: The research aimed to examine whether the carotid condition is linked to coronary artery disease in sufferers sent to exercise echocardiography and when it raises the exercise echocardiography capability to forecast coronary artery disease. Place and Duration: During the last five years, continuous subjects over eighteen years with diagnosed coronary artery disease underwent exercise echocardiography and carotid ultrasound at Indus Hospital Karachi. Study Design: Cross-sectional Methodology: We studied 312 participants without past heart disease who experienced exercise echocardiography, coronary angiography, and carotid ultrasonography over five years. Specific variables had been described as proportions, and evaluation among groups was according to Fisher’s exact and chi-square tests. Constant variables had been described as mean or median whenever their distribution deceased from average, and variations had been evaluated through the un-paired t-test. Continuous and binary quantitative variables have been likened to utilizing binary logistic regression. IBM SPSS, Version 20 was utilized. Results: 178 (57.1 percent) participants had substantial coronary artery disease. Components linked to CAD in multi-variate evaluation were FPG (OR 2.04, p=0.062), pre-test possibility of CAD greater than 65 percent (odds ratio 7.42, p less than0.004), positive exercise echocardiography (odds ratio 42.04, p less than 0.004) and carotid plaque presence (odds ratio 5.8, p= 0.052). There wasn't a statistical factor in the area below the curve after the inclusion of carotid plaque to exercise echocardiography results (3.08 vs. 3.24, p=1.05) nor the level of sensitivity, uniqueness, predictive efficiency, or values. Conclusion: Carotid plaque is linked to CAD in sufferers going through exercise echocardiography (EE), although its inclusion to EE doesn't improve coronary artery disease (CAD) prediction, most likely because of inadequate mathematical power. Carotid plaque reclassified 1 / 3 of sufferers to high risk class in spite of negative exercise echocardiography (EE) or absence of coronary artery disease; these subjects take advantage of aggressive primary prevention treatments.
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Hussain et al. (2022) conducted a cross-sectional in Suspected coronary artery disease (n=312). Carotid plaque presence vs. Absence of carotid plaque was evaluated on Significant coronary artery disease (≥50% stenosis on angiography) (OR 5.9, 95% CI 2.5-13.8, p=0.026). The presence of carotid plaque was significantly associated with coronary artery disease (OR 5.9), although its addition to exercise echocardiography did not significantly improve CAD prediction.
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