Department of Neurology, Medical University of Silesia, Professor Leszek Giec Upper Silesian Medical Centre, Katowice, Poland; School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Department of Neurology, Medical University of Silesia, Professor Leszek Giec Upper Silesian Medical Centre, Katowice, Poland; School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
Pol Arch Intern Med. 2020 May 29;130(5):412-419. doi: 10.20452/pamw.15330. Epub 2020 May 1.
Carotid artery atherosclerosis is a recognized predictor of cardiovascular events. The coexistence of coronary atherosclerosis and cerebrovascular disease is associated with unfavorable clinical outcomes.
The aim of this study was to determine the prevalence of hemodynamically and clinically significant carotid and / or cerebral artery stenosis in patients with stable and unstable coronary artery disease (CAD).
Cardiac and neurological examinations together with coronary angiography and carotid ultrasound were performed in 241 patients, and transcranial Doppler imaging of cerebral arteries in 114. The prevalence of hemodynamically significant internal carotid artery (ICA) stenosis, intracranial artery stenosis, and clinical signs of central nervous system ischemia were compared between patients with stable and unstable CAD.
There was no significant difference in the prevalence of ICA stenosis (15.3% vs 19%) and intracranial artery stenosis (18% vs 16%) between patients with stable and unstable CAD. Risk factors for cerebral artery stenosis included ICA stenosis (odds ratio [OR], 13.21; 95% CI, 5.93-41.89) and advanced CAD (OR, 2.38; 95% CI, 1.13-4.09), and for ischemic events within the central nervous system, ICA stenosis (OR, 1.74; 95% CI, 1.01-3.16) and intracranial artery stenosis (OR, 3.01; 95% CI, 1.66-5.57).
No differences in the prevalence of atherosclerosis of the carotid and cerebral arteries were found between patients with stable and unstable CAD in this study. Advanced CAD is one of the risk factors for hemodynamically significant cerebral artery stenosis.
颈动脉粥样硬化是心血管事件的公认预测因子。冠状动脉粥样硬化和脑血管疾病的共存与不利的临床结局相关。
本研究旨在确定稳定型和不稳定型冠心病（CAD）患者中存在血流动力学和临床上显著的颈动脉和/或脑动脉狭窄的患病率。
对 241 例患者进行了心脏和神经系统检查，以及冠状动脉造影和颈动脉超声检查，对 114 例患者进行了颅多普勒超声检查脑动脉。比较了稳定型和不稳定型 CAD 患者之间存在血流动力学意义的颈内动脉（ICA）狭窄、颅内动脉狭窄和中枢神经系统缺血的临床征象的患病率。
稳定型和不稳定型 CAD 患者的 ICA 狭窄（15.3% vs 19%）和颅内动脉狭窄（18% vs 16%）患病率无显著差异。脑动脉狭窄的危险因素包括 ICA 狭窄（比值比 [OR]，13.21；95%置信区间，5.93-41.89）和高级 CAD（OR，2.38；95%置信区间，1.13-4.09），对于中枢神经系统内的缺血事件，ICA 狭窄（OR，1.74；95%置信区间，1.01-3.16）和颅内动脉狭窄（OR，3.01；95%置信区间，1.66-5.57）。
在本研究中，稳定型和不稳定型 CAD 患者的颈动脉和脑动脉粥样硬化的患病率没有差异。高级 CAD 是血流动力学意义上的脑动脉狭窄的危险因素之一。
