title: Prognostic value of carotid intima-media thickness in detection of coronary atherosclerosis in patients with calcified aortic valve stenosis.
abstract: OBJECTIVE
  Aortic stenosis (AS) coexists with coronary artery disease (CAD) in at least 30% of patients. Patients with concomitant CAD may benefit from simultaneous coronary bypass grafting. This study aimed to evaluate the prognostic value of carotid intima-media thickness (IMT) in patients with AS in assessing concomitant CAD.
  
  
  METHODS
  Group I consisted of 33 patients (mean age +/- SD, 61.0 +/- 8.2 years; 18 men and 15 women) with AS but without CAD on angiograms. Group II consisted of 34 patients (64.4 +/- 8.0 years; 25 men and 9 women) with AS and CAD confirmed angiographically. A control group included 36 patients (61.2 +/- 4.9 years; 18 men and 18 women) with normal coronary arteries and no AS. Maximal IMT was assessed in all patients at the common carotid artery, bulb, and internal carotid artery and expressed as a mean value.
  
  
  RESULTS
  There were no differences among the respective groups with regard to age, sex, frequency of hypertension, diabetes, and smoking habit, although patients with CAD were more often hyperlipemic (P = .038). The IMT of the common carotid artery, bulb, and internal carotid artery was significantly higher in patients with AS and CAD compared with both the control group and patients with AS only. The multivariable regression model revealed that CAD (P < .001), AS (P = .006), male sex (P = .034), age (P < .001), and diabetes mellitus (P = .047) were independent risk factors for IMT thickening. A mean IMT value of greater than 1.2 mm was predictive (sensitivity, 73.5%; specificity, 72.7%) of concomitant CAD in patients with AS.
  
  
  CONCLUSIONS
  Intima-media thickness increases in patients with AS. The greatest IMT values are observed in patients with both AS and CAD. Patients with AS might be suspected of having CAD when the IMT value exceeds 1.2 mm.
authors.affiliation: Department of Cardiac and Vascular Diseases, Institute of Cardiology, Collegium Medicum Jagiellonian University, 31-202 Krakow, Poland. kablakziembicka@op.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Kablak-Ziembicka
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Przewlocki
authors.forename: Wieslawa
authors.initials: W
authors.lastname: Tracz
authors.forename: Piotr
authors.initials: P
authors.lastname: Podolec
authors.forename: Ireneusz
authors.initials: I
authors.lastname: Stopa
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kostkiewicz
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sadowski
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Mura
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Kopeć
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000473:pathology*; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*