Stroke, Vol 23, 946-951, Copyright © 1992 by American Heart Association
H Tanaka, M Nishino, M Ishida, R Fukunaga and K Sueyoshi
BACKGROUND AND PURPOSE: Along with the recent changes in lifestyle in
Japan, the incidence of coronary artery disease has increased while the
incidence of stroke appears to be decreasing. We investigated the relation
between the progression of carotid atherosclerosis and the severity of
coronary artery disease in the Japanese population. METHODS: The 2-year
change in extracranial carotid atherosclerosis in 50 Japanese patients who
underwent coronary angiography was evaluated using carotid echotomography.
To quantify the extent of carotid atherosclerosis, the maximal thickness
measurements of all plaques were summed for an individual plaque score,
except for new plaques found on reexamination. Carotid disease progression
was evaluated by the sum of plaque score change and the thickness of the
new plaque found on reexamination. RESULTS: The plaque score changed by
-3.2 to 10.1 mm (mean +/- SD, 1.06 +/- 2.42 mm). The extent of coronary
atherosclerosis (p less than 0.02) and serum total cholesterol level (p
less than 0.01) were different between the progressing (n = 17) and the
nonprogressing (n = 30) groups of carotid atherosclerosis when the
progressing group included the patients with a delta plaque score of
greater than or equal to 1.0 mm. Neither age, serum triglyceride level,
serum high- density lipoprotein cholesterol level, pack-years of smoking,
percentage of smokers, percentage of hypertensive patients, nor percentage
of diabetic patients was different between the two groups. Carotid disease
progression was significantly higher in patients with three-vessel coronary
disease than in patients without significant coronary artery disease (p
less than 0.005). There was a significant positive linear correlation
between carotid disease progression and Gensini's coronary artery disease
score (R = 0.411, p less than 0.005). CONCLUSIONS: Our data showed that
severe coronary artery disease and a high serum total cholesterol level
were strong predictors for carotid disease progression in Japanese patients
with high rates of coronary artery disease.
ARTICLES
Progression of carotid atherosclerosis in Japanese patients with coronary artery disease
Department of Internal Medicine, Osaka Rosai Hospital, Japan.
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