title: Coronary Artery Disease Screening With Carotid Ultrasound Examination by a Primary Care Physician.
abstract: BACKGROUND
  In this study, we investigated the feasibility of primary care physicians using carotid ultrasound to perform coronary artery disease screening in asymptomatic patients with multiple coronary risk factors.
  
  
  METHODS
  We retrospectively collected the data of 135 consecutive asymptomatic patients (mean age: 68.5 ± 8.4 years; male, 75%) who were referred to our institution due to abnormal findings on a carotid ultrasound performed by a primary care physician and who underwent coronary computed tomography angiography.
  
  
  RESULTS
  The mean number of risk factors was 4.1 ± 1.2 and the mean intima-media thickness was 2.00 ± 0.63 mm. Mild (≤ 50%), moderate (51-75%), and severe (> 76%) coronary stenosis was observed in 54 (40%), 27 (20%), and 25 patients (19%), respectively, while no plaque was found in 24 patients (18%), and five patients (4%) could not be evaluated due to calcification. Consequently, coronary angiography was performed in 56 (41%) patients and coronary intervention was required in 31 patients (23%). A multivariate logistic regression analysis demonstrated that the ratio of low-density lipoprotein cholesterol levels to high-density lipoprotein cholesterol levels, the use of calcium channel blockers and the value of the diastolic blood pressure were related to > 50% coronary stenosis.
  
  
  CONCLUSIONS
  The use of carotid ultrasound in the coronary artery disease screening by primary care physicians resulted in a high prevalence of coronary artery disease and high probabilities of coronary angiography and revascularization, and thus it is considered to be a useful and feasible strategy for the screening of asymptomatic patients.
authors.affiliation: Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan.
authors.forename: Arihide
authors.initials: A
authors.lastname: Okahara
authors.affiliation: Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sadamatsu
authors.affiliation: Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Matsuura
authors.affiliation: Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Koga
authors.affiliation: Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan.
authors.forename: Daigo
authors.initials: D
authors.lastname: Mine
authors.affiliation: Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan.
authors.forename: Keiki
authors.initials: K
authors.lastname: Yoshida
keywords: Asymptomatic; Computed tomography; Coronary angiography; Coronary intervention; Coronary risk factor; Intima-media thickness