Khoury Z, Schwartz R, Gottlieb S, Chenzbraun A, Stern S, Keren A
Heiden Department of Cardiology, Bikur Cholim Hospital and the Hebrew University-Hadassah Medical School, Jerusalem, Israel.
Am J Cardiol. 1997 Dec 1;80(11):1429-33. doi: 10.1016/s0002-9149(97)00701-7.
This prospective study was conducted to correlate the presence of angiographically significant coronary artery disease (CAD) and atherosclerotic disease in the aorta, carotid, and femoral arteries as measured by ultrasound. One hundred two consecutive patients admitted for coronary angiography for suspected CAD participated in the study. All patients underwent transesophageal echocardiography for the evaluation of thoracic aortic atherosclerosis and B-mode ultrasound for evaluation of carotid and femoral atherosclerosis. Intimal-medial thickness > 1 mm in the thoracic aorta or peripheral vessels was considered as evidence of atherosclerosis. Patients with CAD (n = 64) had a significantly higher incidence of atherosclerotic plaques in the thoracic aorta, carotid, and femoral arteries than subjects with normal coronary arteries: 91%, 72%, 77% vs 31%, 47% and 42%, respectively. Extracoronary plaque was a stronger predictor of CAD than conventional risk factors. Evidence of plaque in patients younger than median age (64 years) had a higher specificity than in patients above median age (77% vs 40%, respectively, p <0.0001). Plaque score of the extracardiac vessels was significantly higher in patients with multivessel CAD than in patients with 1-vessel CAD disease and in subjects with normal coronary arteries (p <0.001). Thus, atherosclerotic plaques in the aortic and femoral arteries and, to a lesser extent, in the carotid arteries are strong predictors of CAD.
本前瞻性研究旨在通过超声测量，将血管造影显示的显著冠状动脉疾病（CAD）的存在与主动脉、颈动脉和股动脉的动脉粥样硬化疾病相关联。102例因疑似CAD而接受冠状动脉造影的连续患者参与了该研究。所有患者均接受经食管超声心动图检查以评估胸主动脉粥样硬化，并接受B型超声检查以评估颈动脉和股动脉粥样硬化。胸主动脉或外周血管内膜中层厚度>1mm被视为动脉粥样硬化的证据。CAD患者（n = 64）在胸主动脉、颈动脉和股动脉中出现动脉粥样硬化斑块的发生率显著高于冠状动脉正常的受试者：分别为91%、72%、77%，而后者分别为31%、47%和42%。冠状动脉外斑块比传统危险因素更能预测CAD。年龄低于中位数（64岁）的患者中斑块的证据比年龄高于中位数的患者具有更高的特异性（分别为77%和40%，p<0.0001）。多支冠状动脉疾病患者的心外血管斑块评分显著高于单支冠状动脉疾病患者和冠状动脉正常的受试者（p<0.001）。因此，主动脉和股动脉以及程度较轻的颈动脉中的动脉粥样硬化斑块是CAD的有力预测指标。
