Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
Santa Casa de Misericórdia de Juiz de Fora, Juiz de Fora, Brazil.
J Clin Ultrasound. 2024 Nov-Dec;52(9):1296-1303. doi: 10.1002/jcu.23793. Epub 2024 Aug 27.
Cardiovascular disease represents the foremost cause of death among chronic and non-transmissible diseases. Diagnostic tools commonly used for peripheral and carotid atherosclerosis, such as ankle-brachial index (ABI) and carotid ultrasonography (CU), may contribute as surrogates for the diagnosis of coronary arterial disease (CAD).
We report a cross-sectional study of 50 patients referred to elective invasive coronary angiography (ICA). Patients were submitted to ABI and CU-for carotid intima-media thickness (CIMT) and carotid atherosclerotic plaque screening (CAPS). Clinical and demographic variables were also evaluated. CAD was defined as greater than 50% stenosis in at least one coronary artery.
In logistic regression analysis, only CAPS showed a statistically significant area under the curve (AUC) for CAD prediction: 0.812 (95% CI, p <0.001). ABI and CIMT did not show statistically significant performance. For multivariate logistic regression analysis, the model including variables "gender," "dyslipidemia," "smoking," "pack-years," and CAPS predicted CAD better. The AUC for this model was 0.912 (95% CI, p = 0.002).
The screening for carotid atherosclerotic plaques may enhance traditional risk stratification strategies for CAD. Longitudinal studies and bigger samples of subject are needed to allow extrapolation of our findings.
心血管疾病是慢性非传染性疾病中首要的致死病因。常用于诊断外周动脉和颈动脉粥样硬化的工具，如踝臂指数（ABI）和颈动脉超声（CU），也可作为冠状动脉疾病（CAD）的诊断替代指标。
我们报告了一项对 50 例拟行选择性冠状动脉造影（ICA）的患者进行的横断面研究。患者接受 ABI 和 CU 检查，以筛查颈动脉内膜中层厚度（CIMT）和颈动脉粥样硬化斑块（CAPS）。同时评估了临床和人口统计学变量。CAD 的定义为至少一条冠状动脉存在大于 50%的狭窄。
在逻辑回归分析中，只有 CAPS 对 CAD 预测具有统计学意义的曲线下面积（AUC）：0.812（95%置信区间，p<0.001）。ABI 和 CIMT 没有显示出统计学上的显著表现。对于多变量逻辑回归分析，包含变量“性别”、“血脂异常”、“吸烟”、“吸烟年数”和 CAPS 的模型能更好地预测 CAD。该模型的 AUC 为 0.912（95%置信区间，p=0.002）。
筛查颈动脉粥样硬化斑块可以增强 CAD 的传统风险分层策略。需要进行更多的纵向研究和更大的样本量，以推广我们的发现。
