Silent coronary artery disease in Japanese patients undergoing carotid artery stenting.
BACKGROUND
The aim of this retrospective study was to determine the prevalence of silent coronary artery disease (CAD) and the risk factors associated with concomitant CAD in Japanese patients undergoing carotid artery stenting (CAS).


METHODS
The records of 112 consecutive patients (99 men and 13 women; mean age 70 ± 8 years) who underwent elective CAS at our institution for extracranial carotid artery stenosis between January 2006 and January 2011 were reviewed retrospectively. During this period, preoperative CAD screening by coronary angiography was performed in all patients. Patients were diagnosed with CAD when ≥ 1 coronary arteries had stenosis ≥ 75% and were classified into 2 groups: (1) a group with CAD that was based on preoperative coronary angiography or a history of percutaneous coronary intervention (PCI) and/or coronary artery bypass grafting (CABG), and (2) a group without CAD that had no angiographically documented stenosis ≥ 75%.


RESULTS
Sixteen (14.3%) patients had CAD that had already been treated by PCI and/or CABG. Silent CAD was detected in 39 (34.8%) of 112 patients. Taken together, 55 (49.1%) patients had clinically significant CAD. The patients with CAD were more likely to have diabetes mellitus (DM; P = .001), dyslipidemia (P = .013), and bilateral carotid disease (P = .033). Multivariate analysis revealed that DM (odds ratio 3.07; 95% confidence interval 1.25-7.53) and bilateral carotid stenosis (odds ratio 2.72; 95% confidence interval 1.10-6.75) were independent variables associated with concomitant CAD.


CONCLUSIONS
Perioperative CAD screening revealed that silent CAD was frequently diagnosed in Japanese patients scheduled for CAS, particularly in those with DM and/or bilateral carotid stenosis.
Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan.
Yukiko
Y
Enomoto
Shinichi
S
Yoshimura
Kiyofumi
K
Yamada
Masanori
M
Kawasaki
Kazuhiko
K
Nishigaki
Shinya
S
Minatoguchi
Toru
T
Iwama
D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002339:Carotid Arteries / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
Carotid artery stenting; coronary artery disease; diabetes mellitus