Andrew J O'Brien1,2,3, John Donlan2,3, John I Vrazas1,2,3. 1. Department of Medicine University of Melbourne Parkville Victoria 3010 Australia. 2. St. Vincent's Private Hospital 59-61 Victoria Parade Fitzroy Victoria 3065 Australia. 3. Melbourne Institute of Vascular and Interventional Radiology 59-61 Victoria Parade Fitzroy Victoria 3065 Australia.
Abstract
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.
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.
Authors: Elena Franchi; Paolo Marino; Giuseppe G Biondi-Zoccai; Giuseppe De Luca; Corrado Vassanelli; Pierfrancesco Agostoni Journal: Curr Cardiol Rep Date: 2009-09 Impact factor: 2.931
Authors: Dariush Mozaffarian; Emelia J Benjamin; Alan S Go; Donna K Arnett; Michael J Blaha; Mary Cushman; Sarah de Ferranti; Jean-Pierre Després; Heather J Fullerton; Virginia J Howard; Mark D Huffman; Suzanne E Judd; Brett M Kissela; Daniel T Lackland; Judith H Lichtman; Lynda D Lisabeth; Simin Liu; Rachel H Mackey; David B Matchar; Darren K McGuire; Emile R Mohler; Claudia S Moy; Paul Muntner; Michael E Mussolino; Khurram Nasir; Robert W Neumar; Graham Nichol; Latha Palaniappan; Dilip K Pandey; Mathew J Reeves; Carlos J Rodriguez; Paul D Sorlie; Joel Stein; Amytis Towfighi; Tanya N Turan; Salim S Virani; Joshua Z Willey; Daniel Woo; Robert W Yeh; Melanie B Turner Journal: Circulation Date: 2014-12-17 Impact factor: 29.690
Authors: D W Taylor; H J Barnett; R B Haynes; G G Ferguson; D L Sackett; K E Thorpe; D Simard; F L Silver; V Hachinski; G P Clagett; R Barnes; J D Spence Journal: Lancet Date: 1999-06-26 Impact factor: 79.321
Authors: J R Crouse; J F Toole; W M McKinney; M B Dignan; G Howard; F R Kahl; M R McMahan; G H Harpold Journal: Stroke Date: 1987 Nov-Dec Impact factor: 7.914
Authors: Aaron L Doonan; Juhana Karha; Thomas P Carrigan; Anthony A Bavry; Susan M Begelman; Stephen G Ellis; Jay Yadav; Deepak L Bhatt Journal: Am J Cardiol Date: 2007-07-18 Impact factor: 2.778
Authors: Gerald I Cohen; Rabeea Aboufakher; Renee Bess; John Frank; Mahmoud Othman; Dennis Doan; Nancy Mesiha; Howard S Rosman; Susan Szpunar Journal: JACC Cardiovasc Imaging Date: 2013-11
Authors: Ricardo C Cury; Suhny Abbara; Stephan Achenbach; Arthur Agatston; Daniel S Berman; Matthew J Budoff; Karin E Dill; Jill E Jacobs; Christopher D Maroules; Geoffrey D Rubin; Frank J Rybicki; U Joseph Schoepf; Leslee J Shaw; Arthur E Stillman; Charles S White; Pamela K Woodard; Jonathon A Leipsic Journal: J Cardiovasc Comput Tomogr Date: 2016-06-15