Carotid disease in patients scheduled for coronary artery bypass: Analysisof 678 patients

The purpose of this article is to investigate the frequency of carotid dise ase and to identify high-risk groups among patients scheduled for isolated coronary artery bypass grafting (CABG) procedures under nonemergent conditi ons. A total of 678 consecutive patients underwent preoperative carotid art ery duplex scanning (CADS) before CABG procedures. Morphology of carotid ar tery was determined and five groups were formed. Age, sex, cervical bruit, diabetes mellitus (DM), hypertension, smoking, history of cerebrovascular e vent (CVE), peripheral vascular disease (PVD), and severity of coronary art ery disease were investigated to describe the high-risk group for carotid a rtery disease. In 41% of patients carotid examination produced normal findi ngs; 46.2% had less than 60% luminal stenoses, 7.1% had 60-79% stenoses, 4. 6% had 80-99% stenoses, and 1.2% had total occlusion. Previous cerebral isc hemic events (CVE) (p < 0.05), hypertension (p < 0.01), smoking (p < 0.01), advanced age (p < 0.01), and female sex (p < 0.01) were identified as high -risk factors for carotid artery stenoses. There was a linear association b etween carotid disease and coronary disease (p < 0.05). Documentation of pr evious CVE, hypertension, smoking, advanced age, female sex, and severe cor onary artery disease may be helpful in identifying patients at high risk fo r carotid artery stenoses.