Usefulness of Carotid Ultrasound to Improve the Ability of Stress Testing to Predict Coronary Artery Disease

Kanwar, Manpreet; Rosman, Howard; Fozo, Paul K.; Fahmy, Samer; Vikraman, Narayanan; Gardin, Julius M.; Bess, Renee; Cohen, Gerald I.

doi:10.1016/j.amjcard.2006.12.028

Cited by 25 publications

(19 citation statements)

References 12 publications

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“…In a study of symptomatic patients undergoing coronary angiography, 74% of those with a positive exercise or pharmacological stress test and significant coronary artery stenosis had carotid IMT values >75th percentile, compared with 44% of those without significant CAD 25. In asymptomatic diabetic subjects, higher carotid IMT values have been shown to be highly predictive of ischaemia on radionuclide myocardial perfusion imaging 26.…”

Section: Association Among Carotid Imt Myocardial Ischaemia and Coromentioning

confidence: 99%

Carotid intima–media thickness: ultrasound measurement, prognostic value and role in clinical practice

Nair

Malik

Khattar

2012

Postgraduate Medical Journal

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Ultrasound measurement of carotid intima-media thickness (IMT) has become a valuable tool for detecting and monitoring progression of atherosclerosis and recently published recommendations provide guidance for proper standardisation of these measurements. Important determinants of carotid IMT include age, gender, systolic blood pressure, diabetes mellitus and serum cholesterol levels. Many studies have shown carotid IMT to correlate with the severity of coronary atherosclerosis assessed by CT coronary calcification scores, coronary angiography and intravascular ultrasound. Consistent with its correlation with cardiovascular risk factors and coronary artery disease, a meta-analysis of large observational studies has shown carotid IMT to be a strong predictor of future cardiovascular events. Moreover, in patients with established coronary artery disease a reduction in carotid IMT has been shown to translate into a reduction in future cardiovascular events. Consensus statements now also recommend carotid IMT measurements to further refine the prognostic assessment of patients traditionally considered to be at an intermediate risk of cardiovascular disease.

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Section: Association Among Carotid Imt Myocardial Ischaemia and Coromentioning

confidence: 99%

Carotid intima–media thickness: ultrasound measurement, prognostic value and role in clinical practice

Nair

Malik

Khattar

2012

Postgraduate Medical Journal

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“…Carotid disease, defined as carotid intima‐media thickness (CIMT) and/or the presence of plaques, has been associated in epidemiological studies with myocardial infarction, stroke, and death, and its study improves the ability of risk functions to predict cardiovascular events . It has also showed its utility for coronary artery disease (CAD) diagnosis in patients with ischemic heart disease suspicion scheduled for invasive and noninvasive diagnostic testing . In that sense, American and European guidelines on the management of stable CAD agree that a history of cerebrovascular or peripheral artery disease increases the likelihood of CAD and ultrasound assessment of the carotid arteries in patients with suspected CAD without known atherosclerotic disease is a grade IIa level C recommendation for diagnosis and preventive purposes in the European guidelines .…”

Section: Introductionmentioning

confidence: 99%

Usefulness of carotid ultrasonography in the assessment of coronary artery disease extension in patients undergoing exercise echocardiography

et al. 2018

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Fundación Ramón Dominguez para la Investigación, el Desarrollo y la Innovación biosanitaria" placed in Santiago de Compostela (Spain). Objectives: To evaluate whether carotid disease is associated with coronary artery disease (CAD) extension in patients undergoing treadmill exercise stress echocardiography (EE). Methods: We retrospectively studied 156 patients without previous vascular disease who underwent EE, carotid ultrasonography, and coronary angiography between 2002 and 2013. Low-, intermediate-, and high-risk EE were defined as negative, localized ischemia, and multivessel/extensive ischemia EE respectively; carotid disease according to Mannheim and American Society of Echocardiography Consensus and CAD extension from zero to three vessel disease as stenosis ≥50% by visual assessment.Results: Of the 156 patients, 67 (42.9%), 43 (27.6%), 22 (14.1%), and 24 (15.4%) had zero, one, two, and three vessel disease respectively. Age (P = 0.047), male sex (P = 0.010), diabetes mellitus (P = 0.039), smoking habit (P = 0.015), fasting plasma glucose (P = 0.021), European Systematic COronary Risk Evaluation (P = 0.003), pre test CAD probability (P = 0.003), high-risk EE (P < 0.001), and carotid plaque presence (CP) (P < 0.001) were associated in univariate analysis with more extensive CAD. Predictors of CAD extension in multivariate analysis were high-risk EE (odds ratio [OR] 2.42, P < 0.001), CP presence (OR 1.75, P = 0.004), and pretest CAD probability >65% (OR 1.49, P = 0.023). CP was also associated with multivessel CAD in the 53 patients with low-or intermediate-risk EE (P = 0.001).Conclusions: CP is associated with CAD extension in patients with ischemic heart disease suspicion undergoing EE. Patients with CP could benefit from a more aggressive therapeutic strategy regarding patients without carotid disease and similar risk EE, especially in intermediate-and/or low-risk test where guidelines recommend initially optimal medical treatment. K E Y W O R D Scarotid artery disease, coronary artery disease, exercise echocardiography | 337 FRANCO-GUTIÉRREZ ET Al.

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“…The MESA study showed that coronary calcium, a gauge of plaque burden, is more specific but less sensitive than CIMT [3]. Kanwar found that the presence of carotid plaque was an independent predictor of vascular events [4]. ARBITER 2 and 3 found that CIMT changes attributable to higher HDL cholesterol were well below those predicted by HATS [5][6][7].…”

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confidence: 99%

“…A low heart-rate recovery (HRR) has been found to be an independent predictor of mortality in many studies [1][2][3][4][5][6][7][8], even when adjusting for other important factors, e.g. left ventricular function [2], exercise capacity, or angiographic severity of coronary artery disease [4].…”

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confidence: 99%

Could the sonographic characterization of carotid plaque improve the surrogacy of intima-media thickness for vascular outcomes?

Bliman

2010

International Journal of Cardiology

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Usefulness of Carotid Ultrasound to Improve the Ability of Stress Testing to Predict Coronary Artery Disease

Cited by 25 publications

References 12 publications

Carotid intima–media thickness: ultrasound measurement, prognostic value and role in clinical practice

Carotid intima–media thickness: ultrasound measurement, prognostic value and role in clinical practice

Usefulness of carotid ultrasonography in the assessment of coronary artery disease extension in patients undergoing exercise echocardiography

Could the sonographic characterization of carotid plaque improve the surrogacy of intima-media thickness for vascular outcomes?

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