title: The presence of a calcific plaque in the common carotid artery as a predictor of coronary atherosclerosis.
abstract: Many contradictory reports have been published investigating the relationship between coronary artery disease (CAD) and the increased intima-media thickness (IMT) in the common carotid artery (CCA). However, only a limited number of studies evaluate the relationship between CAD and CCA disease as reflected by both the plaque morphology (fibrous and calcific plaques) and IMT. We have studied the associations between CAD and the wall morphology of CCA by B-mode ultrasound (US). One hundred and forty-four subjects, whose angiography was planned on the basis of suspected CAD, were included into the study. The patients were divided into 4 groups on the basis of B-mode US findings; Group I: normal, Group II: increased IMT (IMT >/= 0.8 mm and plaque absent), Group III: fibrous plaque, Group IV: calcific plaque. Coronary artery disease was diagnosed in 63 patients. A statistically significant correlation was found between CAD and CCA wall morphology (r =0.42, CI (95%) = 0.30-0.51, p<0.001). Positive predictive values were 45.0%, 48.4%, and 75.0% in patients with increased IMT, fibrous plaque, and calcific plaque, respectively. None of the women with normal CCA wall morphology had significant coronary artery lesion. With respect to the normal group, the risk for CAD increased by 4.3 fold with the existence of fibrous plaque (p=0.02) and by 9.9 fold with the existence of calcific plaque (p<0.001). It has been shown that the CCA wall morphology determined by B-mode US is correlated with CAD in patients with chest pain, and the presence of calcific plaque is a better predictor for CAD than that of fibrous plaque and increased IMT. Women with chest pain and normal CCA wall morphology may not need coronary angiography.
authors.affiliation: Cukurova University, School of Medicine, Departments of Cardiology, Adana, Turkey. kanadasi@cu.edu.tr
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanadaşi
authors.forename: Murat
authors.initials: M
authors.lastname: Cayli
authors.forename: Mustafa
authors.initials: M
authors.lastname: San
authors.forename: Kairgeldy
authors.initials: K
authors.lastname: Aikimbaev
authors.forename: C Cumhur
authors.initials: CC
authors.lastname: Alhan
authors.forename: Mesut
authors.initials: M
authors.lastname: Demir
authors.forename: Mustafa
authors.initials: M
authors.lastname: Demirtaş
mesh_terms: D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography