Asymptomatic carotid artery disease in patients with significant coronary artery disease undergoing coronary artery bypass grafting.

Mehta, A.; Passey, R.; Dhawan, S.; Sachdeva, S.; Mohan, R.; Mantri, R.R.; Sawhney, J.P.S.; Chopra, V.K.; Bana, A.; Shivani, G.; Yadav, O.P. and Khanna, P.K. (2002) Asymptomatic carotid artery disease in patients with significant coronary artery disease undergoing coronary artery bypass grafting. Supplement to the Journal of the American College of Cardiology, 39 (9). 27B.

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Abstract

Many studies have identified the interrelationship between carotid artery disease (CD) and coronary artery disease (CAD). The purpose of this study was to evaluate the incidence of carotid artery disease by carotid doppler study using Hewlett Packard Sonos 2500 machine with 5.0-7.5 Mhz probe, in patients hospitalized for diagnostic coronary angiography and then subsequently reffered for coronary artery by pass grafting. 496 patients (318 males and 178 females) with significant coronary artery disease were studied. Patients were divided into three groups according to distribution of CAD. 74 patients had left main disease with or without any other artery involvement, 333 patients had 3 vessel disease without it main disease. 90 patients (18.2%) had significant carotid artery disease (stenosis > or =50%) who were identified by carotid doppler. Our study confirmed the relatively high frequency of CD in patients with CAD and also there was correlation between the degree of the CD and extent of CAD. There were 29 out of 74 patients (39.3%) of left main disease who had significant CD, 51 patients (15.4%) out of 333 patients of 3 vessel disease. 10 patients (10.9%) out of 89 patients with 1 or 2 vessel disease had significant CD. There was a high incidence of asymptomatic CD in all groups of patients (56 out of 90 (62%), it was particularly high in patients with left main disease (20 asymptomatic out of 29 patients (68.9%), as compared to patients with 3vessel disease (29 patients (70.8%)), 2/1 vessel disease (6 patients (62.8%)). This study justifies the use of routine carotid echo duplex investigation in patients with significant CAD even if they are asymptomatic of any cerebrovascular disease.

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