Antonini-Canterin Francesco, Leiballi Elisa, Capanna Michele, Burelli Claudio, Cassin Matteo, Macor Franco, Grandis Umberto, Nicolosi Gian Luigi
Cardiologia, ARC, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy.
Angiology. 2009 Oct-Nov;60(5):596-600. doi: 10.1177/0003319708327646. Epub 2008 Dec 1.
Patients with aortic stenosis have a high prevalence of coronary artery disease, but there is little information about the association of coronary artery disease and carotid artery disease.
The study includes 317 consecutive patients with aortic stenosis, who underwent carotid and coronary angiography during the same catheterization before aortic valve replacement.
At univariate analysis, the prevalence of coronary artery disease was associated with (1) presence of carotid artery disease (P < .001); (2) angina pectoris as presentation symptom (P < .001); (3) age more than 65 years (P < .05); and (4) hypertension (P < .05). At multivariate analysis, only carotid artery disease, angina, and age emerged as independent predictors of coronary artery disease. The combination of 2 variables (carotid artery disease, angina) allowed the identification of 4 groups, with decreasing prevalence of coronary artery disease: (1) angina+/carotid artery disease+: 85%; (2) angina-/ carotid artery disease+: 50%; (3) angina+/carotid artery disease-: 41%; (4) angina-/carotid artery disease-: 21% (P < .001).
In patients with symptomatic aortic stenosis, the presence of significant carotid artery disease is a strong marker of significant coronary artery disease.
主动脉瓣狭窄患者中冠状动脉疾病的患病率很高，但关于冠状动脉疾病与颈动脉疾病之间关联的信息却很少。
该研究纳入了317例连续性主动脉瓣狭窄患者，这些患者在进行主动脉瓣置换术前的同一导管插入术中接受了颈动脉和冠状动脉造影。
在单因素分析中，冠状动脉疾病的患病率与以下因素相关：（1）存在颈动脉疾病（P <.001）；（2）以心绞痛为表现症状（P <.001）；（3）年龄超过65岁（P <.05）；（4）高血压（P <.05）。在多因素分析中，只有颈动脉疾病、心绞痛和年龄是冠状动脉疾病的独立预测因素。两个变量（颈动脉疾病、心绞痛）的组合可分为4组，冠状动脉疾病患病率逐渐降低：（1）心绞痛+/颈动脉疾病+：85%；（2）心绞痛-/颈动脉疾病+：50%；（3）心绞痛+/颈动脉疾病-：41%；（4）心绞痛-/颈动脉疾病-：21%（P <.001）。
在有症状的主动脉瓣狭窄患者中，显著颈动脉疾病的存在是显著冠状动脉疾病的有力标志。
