RELATION OF CORONARY-ARTERY DISEASE TO ATHEROSCLEROTIC DISEASE IN THEAORTA, CAROTID, AND FEMORAL ARTERIES EVALUATED BY ULTRASOUND

This prospective study was conducted to correlate the presence of angi ographically significant coronary artery disease (CAD) and atheroscler otic disease in the aorta, carotid, and femoral arteries as measured b y ultrasound. One hundred two consecutive patients admitted for corona ry angiography for suspected CAD participated in the study. All patien ts underwent transesophageal echocardiography for the evaluation of th oracic 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 o f atherosclerosis. Patients with CAD (n = 64) had a significantly high er 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 wa s 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%, respective ly, p <0.0001). Plaque score of the extracardiac vessels was significa ntly higher in patients with multivessel CAD than in patients with 1-v essel 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 predictor s of CAD. (C) 1997 by Excerpta Medica, Inc.