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(Stroke. 2008;39:1597.)
© 2008 American Heart Association, Inc.

Research Letters

Morphological But Not Functional Changes of the Carotid Artery Are Associated With the Extent of Coronary Artery Disease in Patients With Preserved Left Ventricular Function

Kenichi Sugioka, MD; Takeshi Hozumi, MD; Shinichi Iwata, MD; Hiroki Oe, MD; Takuhiro Okuyama, MD; Nobuyuki Shirai, MD; Hajime Yamashita, MD; Shoichi Ehara, MD; Toru Kataoka, MD; Junichi Yoshikawa, MD; Makiko Ueda, MD Minoru Yoshiyama, MD

From the Departments of Internal Medicine and Cardiology (K.S., T.H., S.I., H.O., T.O., N.S., H.Y., S.E., T.K., M.Y.) and Pathology (M.U.), Osaka City University Graduate School of Medicine, Osaka, Japan; and the Department of Cardiology (J.Y.), Osaka Ekisaikai Hospital, Osaka, Japan.

Correspondence to Takeshi Hozumi, MD, Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. E-mail take-hzm{at}wb3.so-net.ne.jp

Abstract

Background and Purpose— The atherosclerotic process is associated with both morphological and functional changes in the carotid artery. We evaluated the relationship between these parameters of the carotid artery and the extent of coronary artery disease (CAD) in patients with preserved left ventricular function.

Methods— The study population consisted of 104 stable patients with CAD who had preserved left ventricular function (left ventricular ejection fraction 45%). All patients underwent carotid ultrasound for evaluation of carotid artery plaque score defined by the sum of plaque thickness, maximum percent area stenosis, and carotid arterial stiffness index β calculated by a combination of changes in carotid arterial diameter and blood pressure.

Results— Plaque score and percent area stenosis correlated with the extent of CAD defined as the number of diseased coronary vessels (P<0.001 and 0.002, respectively), but arterial stiffness β did not (P=0.39). Using logistic regression analyses adjusting for confounding coronary risk factors and arterial stiffness β, plaque score and percent area stenosis were independently correlated with multivessel CAD (P=0.001 and 0.004, respectively).

Conclusions— Carotid artery plaque burden, but not arterial stiffness, is associated with the extent of CAD, suggesting morphological rather than functional changes in the carotid artery may be a more accurate predictor of the extent of CAD and multivessel CAD independent of left ventricular function.

Key Words: atherosclerosis • carotid arteries • coronary artery disease • ultrasonography