Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University , Beijing, China.
Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders , Beijing, China.
Neurol Res. 2020 Jul;42(7):547-553. doi: 10.1080/01616412.2020.1754653. Epub 2020 Apr 14.
Patients with coronary artery disease (CAD) concomitant with extracranial and intracranial atherosclerotic disease (EICAD) may have an increased risk of stroke and myocardial ischemic events. This study aimed to evaluate the concomitant atherosclerotic lesions in extra- and intracranial arterial beds in patients with CAD.
A total of 1274 patients who underwent coronary angiography due to ischemic heart disease were included. All patients underwent ultrasound screening of the extra- and intracranial arteries before coronary angiography, and the degrees of extracranial carotid artery disease (ECAD) and intracranial cerebral artery disease (ICAD) were recorded.
A total of 1062 cases of CAD were confirmed. The prevalence of ECAD, ICAD, and EICAD (ECAD combined with ICAD) in patients with CAD was 15.6%, 11.2% and 11.9%, respectively. For patients with 3-vessel disease, the prevalence was 20.5%, 13.8% and 18.1%, and for patients with severe coronary artery stenosis, the prevalence was 15.8%, 12.1% and 13.2%, respectively. The presence and extent of ECAD and ICAD were positively correlated with the number of lesion vessels and degree of CAD. The posterior circulation arteries were more prone to lesions in patients with ECAD, while the anterior circulation arteries were more vulnerable to lesions in patients with ICAD.
The prevalence of ECAD, ICAD and EICAD is high in patients with CAD, and the presence of these conditions is positively correlated with the extent and degree of CAD. Evaluations of ECAD and ICAD should be highly recommended for CAD patients to reduce the future risk of cardiovascular diseases.
患有冠状动脉疾病（CAD）合并颅外和颅内动脉粥样硬化性疾病（EICAD）的患者可能有更高的中风和心肌缺血事件风险。本研究旨在评估 CAD 患者颅外和颅内动脉床的同时存在的动脉粥样硬化病变。
共纳入 1274 例因缺血性心脏病而行冠状动脉造影的患者。所有患者在冠状动脉造影前行颅外和颅内动脉超声筛查，并记录颅外颈动脉疾病（ECAD）和颅内脑动脉疾病（ICAD）的程度。
共确诊 1062 例 CAD。CAD 患者中 ECAD、ICAD 和 EICAD（ECAD 合并 ICAD）的患病率分别为 15.6%、11.2%和 11.9%。对于 3 支病变的患者，患病率分别为 20.5%、13.8%和 18.1%，对于严重冠状动脉狭窄的患者，患病率分别为 15.8%、12.1%和 13.2%。ECAD 和 ICAD 的存在和严重程度与病变血管数量和 CAD 严重程度呈正相关。ECAD 患者的后循环动脉更容易发生病变，而 ICAD 患者的前循环动脉更容易发生病变。
CAD 患者中 ECAD、ICAD 和 EICAD 的患病率较高，这些情况的存在与 CAD 的严重程度和程度呈正相关。强烈建议对 CAD 患者进行 ECAD 和 ICAD 的评估，以降低未来心血管疾病的风险。
