title: Impact of atherosclerotic changes of carotid vessels on long-term outcome in relatively young patients with acute coronary syndrome.
abstract: BACKGROUND
  Complex stenoses of coronary vessels as well as unstable plaques are part of the widespread atherosclerotic process.
  
  
  OBJECTIVE
  The possible association between the incidence of unstable coronary artery disease (CAD) and the morphology of carotid artery wall and cardiovascular events (MACE) was assessed prospectively in a two-year follow-up study.
  
  
  RESULTS
  Ninety-seven consecutive patients, aged under 60, admitted to hospital with suspected acute coronary syndrome (ACS) were included. Angiography was performed in all patients. Coronary artery disease was confirmed in 78 patients. This was the CAD(+) group. In 19 patients, coronary arteries were normal. This was the CAD(-) group. In all cases, carotid ultrasound was performed before discharge and at two-year follow-up, with evaluation of carotid arteries wall morphology: carotid intima-media thickness (CIMT) in far distal wall of common carotid artery and the presence of plaques. Carotid atherosclerosis was defined as CIMT > 0.9 mm or incidence of plaques; MACE was defined as death, ACS, stroke or need for urgent coronary revascularisation. Sixty patients from the CAD(+) group met the carotid atherosclerosis criteria. This was named the CAR(+) subgroup; 18 patients with normal carotid morphology comprised the CAR(-) subgroup. During the two years, MACE occurred only in the CAD(+) group (22 events). There was no statistical difference in the MACE-free survival curve of the CAR(+) and CAR(-) subgroups (p = 0.91).
  
  
  CONCLUSIONS
  The presence of atherosclerotic process in carotid region coexists well with the incidence of CAD; however, it does not determine prognosis after ACS.
authors.affiliation: 1st Department of Cardiology, Medical University of Silesia, Katowice, Poland. adgerberpl@yahoo.com
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Drzewiecka Gerber
authors.forename: Anna
authors.initials: A
authors.lastname: Rybicka Musialik
authors.forename: Jarosław
authors.initials: J
authors.lastname: Myszor
authors.forename: Damian
authors.initials: D
authors.lastname: Ziaja
authors.forename: Maria
authors.initials: M
authors.lastname: Trusz Gluza
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000328:Adult; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors