Department of Internal Medicine D at Tel-Aviv Sourasky Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Am Coll Cardiol. 2011 Feb 15;57(7):779-83. doi: 10.1016/j.jacc.2010.09.047.
The purpose of this research was to evaluate the relationship between coronary and carotid atherosclerotic disease using current guidelines for the definition of carotid artery stenosis (CAS).
The reported prevalence of concomitant coronary and carotid atherosclerotic disease has varied among studies due to differences in study populations and methodologies used.
We performed a retrospective analysis of prospectively collected data obtained between January 2007 and May 2009 from consecutive patients undergoing same-day coronary angiography and carotid Doppler studies. Spearman correlations and multinomial logistic regression models were used to identify independent correlates of CAS.
The study included 1,405 patients (age 65 ± 11 years, 77.2% male), of whom 12.8% had significant CAS (peak systolic velocity [PSV] >125 cm/s) and 4.6% had severe CAS (PSV >230 cm/s). Mild CAS (PSV <125 cm/s and the presence of a sonographic atherosclerotic lesion) was present in 58%. The severity of CAS and the extent of coronary artery disease (CAD) were significantly correlated (r = 0.255, p < 0.001). Independent predictors of severe CAS defined by PSV were the presence of left-main or 3-vessel CAD, increasing age, a history of stroke, smoking status, and diabetes mellitus.
The degree of internal carotid artery (ICA) stenosis is related to the extent of CAD, though the prevalence of clinically significant ICA stenosis is lower in specific CAD subsets than previously reported.
本研究旨在使用当前颈动脉狭窄（CAS）的定义标准评估冠状动脉和颈动脉粥样硬化疾病之间的关系。
由于研究人群和使用的方法学存在差异，不同研究报道的同时存在冠状动脉和颈动脉粥样硬化疾病的患病率也有所不同。
我们对 2007 年 1 月至 2009 年 5 月期间连续进行同日冠状动脉造影和颈动脉多普勒研究的患者前瞻性收集的数据进行了回顾性分析。采用 Spearman 相关分析和多项逻辑回归模型来确定 CAS 的独立相关因素。
研究共纳入 1405 例患者（年龄 65±11 岁，77.2%为男性），其中 12.8%存在明显的 CAS（收缩期峰值流速[PSV]＞125cm/s），4.6%存在严重的 CAS（PSV＞230cm/s）。轻度 CAS（PSV＜125cm/s 且存在超声粥样硬化病变）占 58%。CAS 的严重程度和冠状动脉疾病（CAD）的严重程度呈显著相关（r=0.255，p＜0.001）。PSV 定义的严重 CAS 的独立预测因子为左主干或 3 支血管 CAD、年龄增大、中风史、吸烟状况和糖尿病。
颈内动脉（ICA）狭窄的程度与 CAD 的严重程度相关，尽管特定 CAD 亚组中临床意义上的 ICA 狭窄的患病率低于之前的报道。
