Morphologic correlation between atherosclerotic lesions of the carotid andcoronary arteries in patients with angina pectoris

The morphology of atherosclerosis between the carotid and coronary artery s ystems was studied in 63 patients with ischemic heart disease to determine if there was a correlation with coronary heart disease. The sclerotic lesio ns of the carotid and coronary artery systems were imaged with ultrasonogra phy and coronary arteriography, respectively, and divided into 4 types. Hem odynamic variables, serum lipid levels, and serum uric acid concentration w ere not different among the groups, but the serum C-reactive protein (CRP) concentration in patients without significant atheroma in the carotid arter y system was lower than the mean concentration of the other 3 groups with c arotid atheroma. The morphological stability of carotid arterial plaques co rrelated well to coronary artery stenosis. Morphologically unstable plaques of the carotid artery predicted unstable forms of coronary obstruction wit h a sensitivity of 68%, specificity of 85%, predictive power of 72% and a l ikelihood ratio of 4.5. These results suggest that ultrasonic examination o f the carotid artery is useful for predicting the presence or absence of un stable lesions in coronary arteries.