Dr Nusrat Ghafoor, Associate Professor & Consultant, Department of Radiology & Imaging, Ibrahim Cardiac Hospital & Research Institute (ICH&RI), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2023 Oct;32(4):1015-1021.
Coronary artery disease (CAD) is one of the important causes of mortality worldwide. South Asians, notably Indians are unduly prone to develop CAD with its incidence being doubled in the last three decades among both rural and urban settlers. CAD prevalence of in Bangladesh is not known. There are merely a limited number of small-scale epidemiological studies are existing. Recent data indicates CAD prevalence in our country to lie between 1.85-3.4% in rural and 19.6% in an urban sample of working professionals. Despite marked disparity in values, the disease seems to be in rising trend. Patients with concomitant CAD and carotid artery disease are at increased risk of developing peri-operative neurological events including stroke. By far, the prevalence of carotid artery disease in candidates of CABG has not yet been determined in our country. There is a lack of pre-operative guidelines as well for the necessary vascular investigations that should be performed on CABG candidates before they go to the operation table. Pre-operative non-invasive carotid Doppler ultrasonography is a useful screening tool for carotid artery disease in all patients undergoing CABG. This was a cross-sectional observational study, was conducted in the Radiology & Imaging department of Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2017 to June 2017. The present cross-sectional study was intended to determine the prevalence of concurrent occurrence of carotid and coronary artery disease in elderly patients undergoing CABG. Total 210 elderly (from 60 & above) patients scheduled for CABG taken as study population. There was bilateral carotid atherosclerotic plaque in 15(12.2%) patients. Right carotid plaque was in 69(56.0%) patients, left carotid plaque in 54(43.9%) patients. Carotid stenosis grading was done in percentage (%). There was significant (>50.0%) stenosis of right carotid system in 12 patients (17.4%) and significant stenosis of left carotid system in 18 patients (33.3%). Right carotid system & bulb was the most common site of plaque formation. We can conclude from this study that a substantial proportion of patients after a particular age possess carotid artery disease simultaneously with coronary artery disease, routine evaluation of carotid arteries of the elderly patients scheduled for CABG is strongly suggested.
冠心病（CAD）是全球重要的死亡原因之一。南亚人，尤其是印度人更容易患上 CAD，在过去三十年中，城乡居民的发病率都增加了一倍。孟加拉国的 CAD 患病率尚不清楚。仅存在少数小规模的流行病学研究。最近的数据表明，我国农村 CAD 患病率为 1.85-3.4%，城市职业人群为 19.6%。尽管数值存在明显差异，但该疾病似乎呈上升趋势。同时患有 CAD 和颈动脉疾病的患者发生围手术期神经事件（包括中风）的风险增加。到目前为止，尚未确定在我国接受 CABG 的患者中颈动脉疾病的患病率。在 CABG 患者接受手术前，也缺乏必要的血管检查的术前指南。对于所有接受 CABG 的患者，术前非侵入性颈动脉多普勒超声检查是颈动脉疾病的有用筛查工具。这是一项横断面观察性研究，于 2017 年 1 月至 2017 年 6 月在孟加拉国达卡的 Ibrahim 心脏医院和研究所放射科和影像科进行。本横断面研究旨在确定接受 CABG 的老年患者同时发生颈动脉和冠状动脉疾病的患病率。共有 210 名（年龄在 60 岁以上）接受 CABG 的老年患者作为研究对象。有 15 名（12.2%）患者双侧颈动脉存在动脉粥样硬化斑块。69 名（56.0%）患者右侧颈动脉有斑块，54 名（43.9%）患者左侧颈动脉有斑块。颈动脉狭窄程度以百分比表示。12 名患者（17.4%）右侧颈动脉系统存在明显（>50.0%）狭窄，18 名患者（33.3%）左侧颈动脉系统存在明显狭窄。右侧颈动脉系统和颈动脉窦是斑块形成最常见的部位。从这项研究中我们可以得出结论，相当一部分特定年龄的患者同时患有颈动脉疾病和冠状动脉疾病，强烈建议对计划接受 CABG 的老年患者的颈动脉进行常规评估。
