# Frequency and risk factors of carotid atherosclerosis in patients with coronary artery disease

## TL;DR

This study finds that most patients with coronary artery disease also have carotid atherosclerosis, with older males and those with severe heart disease being at higher risk.

## Contribution

The study provides new empirical evidence on the prevalence and risk factors of carotid atherosclerosis in CAD patients using an observational approach.

## Key findings

- Carotid atherosclerosis was detected in 71.8% of patients with coronary artery disease.
- Age ≥60 years, male sex, and ≥3-vessel CAD were independently associated with carotid atherosclerosis.
- A syntax score >17 independently predicted carotid atherosclerosis in age- and sex-adjusted models.

## Abstract

Carotid Atherosclerosis is more prevalent among patients with coronary artery disease (CAD). To the best of our knowledge, research on the prevalence of carotid atherosclerosis in CAD patients is mainly based on retrospective cohorts or registries. We aimed to investigate the frequency of carotid atherosclerosis among patients with angiographically proven CAD and to investigate, whether carotid atherosclerosis is more prevalent in special subgroups.

We recruited consecutive patients with angiographically proven CAD, who presented to our cardiology department with manifestations of ischemic heart disease. Carotid atherosclerosis was assessed using ultrasound.

We included 103 patients in our study. Eighty-three (80.6%) patients were males, the mean (± SD) age was 58 (± 9) years. Carotid atherosclerosis was detected in 74 (71.8%) patients. Of those, 6 patients (5.8%) had ≥ 50% stenosis. The ROC curve showed that a syntax score > 17 had a sensitivity of 64.9% and a specificity of 72.4% for carotid atherosclerosis (AUC 0.68, 95% CI 0.57–0.79, p = 0.006). Using a multivariate binary logistic regression after adjusting for age and sex, we found that age ≥ 60 years (OR 5.1, 95% CI 1.64–15.86, p = 0.005), male sex (OR 3.61, 95% CI 1.03–12.67, p = 0.045) and ≥ 3-vessel CAD (OR 4.18, 95% CI 1.06–16.51, p = 0.04) were associated with carotid atherosclerosis. In another age- and sex dependent multivariate logistic regression, syntax score > 17 independently predicted carotid atherosclerosis (OR 4.51, 95% CI 1.68–12.16, p = 0.003).

It seems to be reasonable to conduct carotid ultrasound screening for patients with CAD, especially older males with high syntax score and/or ≥ 3-vessel CAD.