Association between carotid and coronary artery disease in patients with aortic valve stenosis: an angiographic study

Angiology. 2009 Oct-Nov;60(5):596-600. doi: 10.1177/0003319708327646. Epub 2008 Dec 1.

Abstract

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.

MeSH terms

  • Age Factors
  • Aged
  • Angina Pectoris / etiology
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / diagnostic imaging*
  • Aortic Valve Stenosis / epidemiology
  • Aortic Valve Stenosis / surgery
  • 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
  • Female
  • Heart Valve Prosthesis Implantation
  • Humans
  • Hypertension / complications
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Risk Assessment
  • Risk Factors