Carotid plaque is a predictor of major adverse cardiac and cerebrovascular events in patients undergoing coronary angiography.

Abstract

Background:

Carotid disease, measured as carotid intima-media thickness (CIMT) and carotid plaque (CP), is associated with major adverse cardiac and cerebrovascular events (MACCE) in people without the previous atherosclerotic disease; however, there are few published data in patients undergoing coronary angiography. The aim of the study is to determinate if the carotid disease is associated with MACCE after coronary angiography.

Methods:

A total of 390 consecutive patients underwent coronary angiography after exercise echocardiography and carotid ultrasonography between 2002 and 2013. MACCE was defined as stroke, myocardial infarction due to atherosclerosis progression or death due to a stroke or cardiac event.

Results:

Two patients were lost (0.5%). During a mean follow-up of 6.0 years (standard deviation of 2.9), 52 patients (13.4%) suffered MACCE. 1, 5, and 10 years, event-free survival was 96.4% (1.0), 88.7% (1.7), and 81.4% (2.8), respectively. Event rates at 10 years were higher in the CP group (23.2% vs. 10.2%, p = 0.013) and in the CIMT > 0.9 mm group (25.9% vs. 13.3%, p = 0.023). Multivariate analysis showed smoking habit (hazard ratio [HR] 2.51, 95% confidence interval [CI] 1.36-4.62, p = 0.003), glomerular filtration rate (HR 0.98, 95% CI 0.98-0.99), aortic stenosis (HR 2.99, 95% CI 1.24-7.21, p = 0.014), incomplete/no coronary revascularization (HR 1.97, 95% CI 1.06-3.67, p = 0.033), insulin treatment (HR 2.63, 95% CI 1.30-5.31, p = 0.006), and CP (HR 2.36, 95% CI 1.02-5.44, p = 0.044) as predictors of MACCE.

Conclusions:

CP is an independent predictor of MACCE in patients undergoing coronary angiography.

• Authors: Raúl Franco-Gutiérrez, Alberto J Pérez-Pérez, Virginia Franco-Gutiérrez, Raymundo Ocaranza-Sánchez, Ana Testa-Fernández, Manuel L López-Reboiro, Andrea López-López, Melisa Santás-Álvarez, María G Crespo-Leiro, Carlos González-Juanatey
• Journal: Archivos de cardiologia de Mexico (Arch Cardiol Mex) Vol. 89 Issue 1 Pg. 1-7 ( 2019) ISSN: 1665-1731 [Electronic] Mexico
• Vernacular Title: La presencia de placa carotídea es predictor de eventos adversos cardiacos y cerebrovasculares en sujetos sometidos a coronariografía.
• PMID: 31448766 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright: © 2019 Permanyer.

Topics

• Adult
• Aged
• Aged, 80 and over
• Carotid Artery Diseases (complications, diagnosis)
• Coronary Angiography
• Disease Progression
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Infarction (diagnosis, etiology, mortality)
• Plaque, Atherosclerotic (complications, diagnosis)
• Retrospective Studies
• Risk Factors
• Stroke (diagnosis, etiology, mortality)
• Survival Analysis