Department of Internal Medicine, Second Section of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Am J Med Sci. 2009 Dec;338(6):447-52. doi: 10.1097/MAJ.0b013e3181ab1c96.
Coronary artery disease (CAD) is the most important cause of mortality and morbidity in patients who have undergone carotid artery endovascular or surgical intervention. Metabolic syndrome (MetS) and hyperhomocysteinemia (HHCY) have been reported to be associated with CAD. However, no study has investigated the association between MetS or HHCY and the severity of CAD in patients with carotid stenosis.
Total of 148 consecutive patients with at least 1 side of the extracranial internal carotid artery were enrolled. Further, on the basis of the results of coronary angiography, the patients were divided into the CAD group (n = 85) and the non-CAD group (n = 63).
Multiple regression analysis revealed that CAD was independently associated with HHCY (odds ratio: 4.07; 95% confidence interval: 1.93-8.57; P < 0.0001) and MetS (odds ratio: 3.38; 95% confidence interval: 1.56-7.29; P = 0.002). Furthermore, multivariate stepwise linear regression revealed that the MetS score and total plasma homocysteine level were significantly correlated with affected vessel number in CAD and the extent of coronary atherosclerosis.
MetS and HHCY can predict the presence of CAD in patients with carotid stenosis. Furthermore, the MetS score and total plasma homocysteine level are significantly associated with the extent of coronary atherosclerosis.
冠状动脉疾病（CAD）是接受颈动脉血管内或手术干预的患者死亡和发病的最重要原因。代谢综合征（MetS）和高同型半胱氨酸血症（HHCY）与 CAD 有关。然而，尚无研究调查颈动脉狭窄患者中 MetS 或 HHCY 与 CAD 严重程度之间的关系。
共纳入 148 例至少一侧颅外颈内动脉狭窄的连续患者。进一步根据冠状动脉造影结果，将患者分为 CAD 组（n=85）和非 CAD 组（n=63）。
多元回归分析显示，CAD 与 HHCY（比值比：4.07；95%置信区间：1.93-8.57；P<0.0001）和 MetS（比值比：3.38；95%置信区间：1.56-7.29；P=0.002）独立相关。此外，多元逐步线性回归显示，MetS 评分和总血浆同型半胱氨酸水平与 CAD 患者受累血管数量和冠状动脉粥样硬化程度显著相关。
MetS 和 HHCY 可预测颈动脉狭窄患者 CAD 的发生。此外，MetS 评分和总血浆同型半胱氨酸水平与冠状动脉粥样硬化程度显著相关。
