title: Prevalence of Carotid Artery Disease among Ambulatory Patients with Coronary Artery Disease.
abstract: BACKGROUND
  Concomitant carotid artery disease (CaAD) in patients with coronary artery disease (CAD) is associated with worse cardiac and neurologic outcomes. The reported prevalence and risk factors for concomitant CaAD in CAD patients varied among previous studies.
  
  
  OBJECTIVE
  To examine these factors in ambulatory patients with CAD and well-documented cholesterol levels treated with cholesterol-lowering medications.
  
  
  METHODS
  We retrospectively analyzed prospectively collected data from 325 unselected patients with CAD (89 women, mean age 68.8 ± 9.9 years) undergoing routine evaluation at the coronary clinic of our hospital.
  
  
  RESULTS
  The low density lipoprotein-cholesterol (LDL-C) was < 100 mg/dl in 292 patients (90%). Age at onset of CAD symptoms was 59.4 ± 10.8 years. Carotid stenosis ≥ 50% was seen in 83 patients (25.5%) and between 30% and 49% in 55 patients (17%) (duplex method). Carotid stenosis was significantly associated with hypertension (P = 0.032), peripheral arterial disease (P = 0.002) and number of coronary arteries with ≥ 50% stenosis (P = 0.002), and showed a borderline association with age at CAD onset (P = 0.062) and diabetes mellitus (P = 0.053). On linear regression analysis, independent predictors of CaAD were peripheral vascular disease (OR 3.186, 95% CI 1.403-7.236, P = 0.006), number of coronary arteries with ≥ 50% stenosis (OR 1.543, 95% CI 1.136-2.095, P = 0.005), and age at CAD onset (OR 1.028, 95% CI 1.002-1.054, P = 0.003). None of the variables studied predicted freedom from CaAD.
  
  
  CONCLUSIONS
  Carotid atherosclerosis is very common in stable ambulatory patients with CAD regularly taking statins. The risk is higher in patients with peripheral arterial disease, a greater number of involved coronary arteries, and older age at onset of CAD.
authors.forename: Shirit
authors.initials: S
authors.lastname: Kazum
authors.forename: Alon
authors.initials: A
authors.lastname: Eisen
authors.forename: Eli I
authors.initials: EI
authors.lastname: Lev
authors.forename: Zaza
authors.initials: Z
authors.lastname: Iakobishvili
authors.forename: Alejandro
authors.initials: A
authors.lastname: Solodky
authors.forename: David
authors.initials: D
authors.lastname: Hasdai
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
authors.forename: Aviv
authors.initials: A
authors.lastname: Mager
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000453:epidemiology*; D016893:Carotid Stenosis / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D058729:Peripheral Arterial Disease / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors