[Patients with carotid stenosis and clinical history negative for coronary disease. Usefulness of the ergometric test for the identification of ischemic myocardial disease].

BACKGROUND

The purpose of this study was to evaluate, by Stress-Exercise Electrocardiography (SE), the presence of Coronary Artery Disease (CAD) in patients with asymptomatic or symptomatic carotid stenosis, who had no history of myocardial ischemia.

MATERIALS, METHODS AND RESULTS: 133 patients with significant carotid stenosis (> = 50%) were consecutively studied according to an established vascular protocol. Of 92 patients with no history of CAD, 3 were excluded, 4 with bilateral carotid occlusion underwent an Echocardiography-Stress Test with Dipyridamole (ED) with negative result. 85 patients underwent a SE. The result was negative in 50 patients, positive in 21. In 14 patients the SE was uncertain so that they underwent an ED or stress thallium-201 myocardial scintigraphy with positive result in 2. No correlation between the degree of carotid stenosis and the positive SE in patients with significant carotid artery atherosclerosis was found.

CONCLUSIONS

Our study demonstrates that about 25% of patients with significant asymptomatic and symptomatic carotid stenosis and no history of CAD had a latent myocardial ischemia and that the screening of these patients with SE is easy, inexpensive and safe and allow us to detect those who need a more active treatment.