Association between Carotid and Coronary Artery Disease in Patients with Aortic Valve Stenosis: An Angiographic Study

• Published in: Angiology Vol. 60; no. 5; pp. 596 - 600
• Main Authors: Antonini-Canterin, Francesco, Leiballi, Elisa, Capanna, Michele, Burelli, Claudio, Cassin, Matteo, Macor, Franco, Grandis, Umberto, Nicolosi, Gian Luigi
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-10-2009; Sage Publications
• Subjects: Age Factors; Aged; Angina Pectoris - etiology; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - epidemiology; Aortic Valve Stenosis - surgery; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Carotid Artery Diseases - complications; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Coronary Angiography; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Diseases of the aorta; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Heart Valve Prosthesis Implantation; Humans; Hypertension - complications; Male; Medical sciences; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Prevalence; Prospective Studies; Risk Assessment; Risk Factors; coronary artery disease; aortic valve stenosis; carotid artery disease; Human; Aortic stenosis; Angiography; Cardiac valvular disease; Blood vessel; Carotid; Cardiovascular disease; Circulatory system; Coronary heart disease; Aortic valve; Artery
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/0003319708327646

Background
Patients with aortic stenosis have a high prevalence of coronary artery disease, but there is little information about the association of coronary artery disease and carotid artery disease.
Methods
The study includes 317 consecutive patients with aortic stenosis, who underwent carotid and coronary angiography during the same catheterization before aortic valve replacement.
Results
At univariate analysis, the prevalence of coronary artery disease was associated with (1) presence of carotid artery disease (P < .001); (2) angina pectoris as presentation symptom (P < .001); (3) age more than 65 years (P < .05); and (4) hypertension (P < .05). At multivariate analysis, only carotid artery disease, angina, and age emerged as independent predictors of coronary artery disease. The combination of 2 variables (carotid artery disease, angina) allowed the identification of 4 groups, with decreasing prevalence of coronary artery disease: (1) angina+/carotid artery disease+: 85%; (2) angina—/ carotid artery disease+: 50%; (3) angina+/carotid artery disease—: 41%; (4) angina—/carotid artery disease—: 21% (P < .001).
Conclusion
In patients with symptomatic aortic stenosis, the presence of significant carotid artery disease is a strong marker of significant coronary artery disease.